Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.016
Filter
1.
Radiol. bras ; 55(1): 54-61, Jan.-Feb. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360668

ABSTRACT

Abstract Cerebral venous thrombosis (CVT) is an uncommon condition that is potentially reversible if properly diagnosed and promptly treated. Although CVT can occur at any age, it most commonly affects neonates and young adults. Clinical diagnosis is difficult because the clinical manifestations of CVT are nonspecific, including headache, seizures, decreased level of consciousness, and focal neurologic deficits. Therefore, imaging is crucial for the diagnosis. Radiologists should be able to identify the findings of CVT and to recognize potential imaging pitfalls that may lead to misdiagnosis. Thus, the appropriate treatment (anticoagulation therapy) can be started early, thereby avoiding complications and unfavorable outcomes.


RESUMO A trombose venosa cerebral (TVC) é uma condição incomum que é potencialmente reversível se diagnosticada corretamente e prontamente tratada. Embora a TVC possa ocorrer em qualquer idade, ela afeta mais comumente neonatos e adultos jovens. O diagnóstico clínico é difícil porque as manifestações clínicas da TVC são inespecíficas, como cefaleia, convulsões, diminuição do nível de consciência e déficits neurológicos focais. Nesse contexto, a imagem é crucial para o diagnóstico e os radiologistas devem ser capazes de identificar os achados de TVC e reconhecer potenciais armadilhas de imagem que podem levar a diagnósticos incorretos. Portanto, o tratamento adequado (terapia anticoagulante) deve ser iniciado precocemente para evitar complicações e desfechos desfavoráveis.

3.
Journal of Medical Biomechanics ; (6): E105-E111, 2022.
Article in Chinese | WPRIM | ID: wpr-920676

ABSTRACT

Objective To explore the relationship between the establishment of collateral circulation caused by iliac vein compression syndrom(IVCS) and the deep venous thrombosis (DVT). Methods Different types of ideal collateral circulation models and IVCS patient-specific models were numerically simulated using computational fluid dynamics (CFD) in combination with the blood stasis model. The relationship between blood retention and collateral types and cross-sectional area was studied, and the relationship with thrombosis was explored. Results Wall shear stress (WSS) at the distal end part of each ideal model was 0.3 Pa. After four cardiac cycles, the residual blood stayed at the stenosis and the distal end part for the lumbar ascending and pelvic type models, the old blood volume fraction (OBVF) varied with collateral cross-sectional areas, ranging from 5%-90% and 70%-80%, respectively. The OBVF of the coexistence model was above 80%. The WSS at the distal end part of the patient-specific model was 0.9 Pa, and the OBVF at the distal end part was 51.5%. Conclusions The stenosis and the distal end part are most prone to blood stasis, and closely related with DVT. The larger the collateral cross-sectional area, the more serious the blood stagnation. Blood stagnation of the coexistence model is higher compared with the model with lumbar ascending type and pelvic type.

4.
MedUNAB ; 24(3): 340-346, 202112.
Article in Spanish | LILACS | ID: biblio-1353595

ABSTRACT

Introducción. El tromboembolismo pulmonar y la trombosis venosa profunda son urgencias cardiovasculares relativamente comunes, se han descrito diferentes predictores clínicos para la estratificación del riesgo, biomarcadores séricos y pruebas de imagenología. Dentro de los biomarcadores séricos se ha descrito el dímero D. Debido a que la enfermedad tromboembólica venosa es un reto diagnóstico para el clínico, el objetivo del presente estudio fue evaluar la pertinencia de la solicitud del dímero D, en el servicio de urgencias de un centro de tercer nivel en la ciudad de Bogotá durante los años 2018-2019. Metodología. Estudio observacional, descriptivo y transversal retrospectivo de pacientes que consultaron al servicio de urgencias, de una clínica de tercer nivel, de la ciudad de Bogotá, durante el periodo 2018-2019. Resultados. Se revisaron 583 historias clínicas, se excluyeron 107 pacientes, con un total final de 474 (57.3% mujeres y 42.6% hombres). De estos, 21 pacientes presentaron estudios positivos (angiotomografía y Doppler venoso). El dímero D presentó un valor predictivo negativo inferior al 50%. Discusión. A pesar de los resultados y de ser un estudio de un solo centro se evidencian las dificultades que tienen los médicos de los servicios de urgencias al momento de solicitar pruebas diagnósticas. Conclusiones. Este estudio evidencia la dificultad que existe en los servicios de urgencias al momento de la evaluación diagnóstica y cómo la solicitud de los paraclínicos tiene que ser un proceso estandarizado, guiado por los motivos de consulta y hallazgos al examen físico, y así no perder las características operativas de las pruebas diagnósticas y su utilidad al momento de la evaluación clínica.


Introduction. Pulmonary thromboembolisms and deep vein thromboses are relatively common cardiovascular emergencies. Various clinical predictors, serial biomarkers and imaging tests have been described for the stratification of the risk. D-dimer has been described within the serial biomarkers. Since venous thromboembolic disease is a diagnostic challenge for doctors, the objective of this study was to assess the pertinence of the D-dimer request in emergency services in a level three center in Bogotá during 2018-2019. Methodology. An observational, descriptive and cross-sectional retrospective study of patients who resorted to emergency services in a level three clinic in Bogotá during 2018-2019. Results. 583 medical records were reviewed, and 107 patients were excluded, with a final total of 474 patients (57.3% women and 42.6% men). Of these, 21 patients had positive studies (angiotomography and venous doppler ultrasound). D-dimer had a negative predictive value of less than 50%. Discussion. Despite the results and it being a study in a single clinic, the difficulties emergency service doctors experience when requesting diagnostic tests can be observed. Conclusions. This study shows the difficulties in emergency services when performing a diagnosis. The request for complementary tests has to be a standardized process guided by the reasons for the consultation and findings from the physical exam, in order not to lose the operational characteristics of the diagnostic tests and their usefulness during the clinical evaluation.


Introdução. Tromboembolismo pulmonar e trombose venosa profunda são emergências cardiovasculares relativamente comuns. Têm sido descritos diferentes preditores clínicos para estratificação de risco, biomarcadores séricos e testes de imagem. Entre os biomarcadores séricos, foi descrito o D-dímero. Considerando que a doença tromboembólica venosa é um desafio diagnóstico para o clínico, o objetivo deste estudo foi avaliar a relevância da solicitação de D-dímero no serviço de emergência de um centro de terceiro nível na cidade de Bogotá ao longo dos anos 2018-2019. Metodologia. Estudo observacional, descritivo e transversal retrospectivo de pacientes que consultaram o serviço de emergência de uma clínica de terceiro nível na cidade de Bogotá, no período de 2018-2019. Resultados. Foram revisados 583 prontuários, excluídos 107 pacientes, totalizando 474 (57.3% mulheres e 42.6% homens). Destes, 21 pacientes apresentaram estudos positivos (angiotomografia e Doppler venoso). D-dímero apresentou valor preditivo negativo inferior a 50%. Discussão. Apesar dos resultados e do fato de se tratar de um estudo só de um centro, são evidentes as dificuldades que os médicos de emergência apresentam ao solicitarem exames diagnósticos. Conclusões. Este estudo mostra a dificuldade que existe nos serviços de emergência no momento da avaliação diagnóstica e como a solicitação dos testes paraclínicos tem que ser um processo padronizado, orientado pelos motivos da consulta e pelos resultados do exame físico, e assim não perder as características operacionais dos exames diagnósticos e sua utilidade no momento da avaliação clínica.


Subject(s)
Pulmonary Embolism , Probability , Venous Thrombosis , Diagnostic Errors , Computed Tomography Angiography
5.
Infectio ; 25(4): 293-295, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1286725

ABSTRACT

Resumen La trombosis venosa cerebral (TVC) es una presentación clínica poco común del tromboembolismo venoso caracterizada por cefalea, crisis convulsivas, déficits neurológicos focales y papiledema. El diagnóstico es confirmado con Tomografía axial computarizada (TAC) de cráneo y Resonancia magnética nuclear (RMN) cerebral. La TVC tiene una relación importante con el virus de inmunodeficiencia humana (VIH), ya que los pacientes VIH positivos cursan con hiperviscosidad san guínea, alteraciones de factores anticoagulantes endógenos y riesgo de sobreinfección, entre otros; que predisponen a estados protrombóticos y lesión vascular como lo es la TVC. El tratamiento de la TVC es terapia anticoagulante, por lo general se utiliza heparina no fraccionada o heparina de bajo peso molecular para la fase aguda y anticoagulantes orales como la warfarina para el mantenimiento posterior. Reportamos el primer caso documentado de TVC en un paciente VIH positivo en Colombia.


Abstract Cerebral venous thrombosis (CVT) is a rare clinical presentation of venous thromboembolism characterized by headache, seizures, neurological deficits and papi lledema. The diagnosis is confirmed using computed tomography scan (CT scan) and magnetic resonance imaging (MRI) of the brain. CVT has an important relationship with the human immunodeficiency virus (HIV) given that HIV-positive patients may present with blood hyperviscosity, irregular levels of endogenous anticoagulation factors and risk of sepsis among others, that predispose to prothrombotic states and vascular injury such as CVT. The treatment of CVT is anticoagulant therapy, generally unfractionated heparin or low molecular weight heparin for the early phase and oral anticoagulants such as warfarin for the late phase. This case reports the first documented case of CVT in an HIV positive patient in Colombia.


Subject(s)
Humans , Male , Adult , Venous Thromboembolism , Skull , Brain , Magnetic Resonance Imaging , HIV , Headache , Hepatitis B
6.
Infectio ; 25(4): 289-292, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1286724

ABSTRACT

Resumen La trombosis de senos venosos cerebrales es un evento infrecuente en la población pediátrica y sus manifestaciones clínicas pueden variar dependiendo de la localización y extensión de la lesión, etiología o grupo etario (1); así mismo, la asociación de esta patología con virus es poco común, sin embargo, se han repor tado casos de trombosis de senos venosos en pacientes adultos con SARS-CoV-2 en relación con los mecanismos de lesión endotelial y respuesta inflamatoria que desencadena mecanismos procoagulantes. A continuación se presenta el primer caso reportado en Colombia de un caso de trombosis venosa cerebral en un lactante previamente sano, que debuta con un cuadro infeccioso gastrointestinal que resuelve y una semana después se presenta con cefalea y paralisis del VI par craneal derecho. Se documentó por angioto mografía trombosis del seno venoso sagital con extensión a senos transversos; los laboratorios fueron negativos para otras causas sistémicas y con prueba de anticuerpos para coronavirus positiva.


Abstract Cerebral venous sinus thrombosis is infrequent in the pediatric population and its clinical manifestations may vary depending on the anatomical location and the extent of the lesion, etiology or age group(1). The association of this pathology with viruses is uncommon, however, cases in adults with SARS-Cov2 have been reported triggered by procoagulant mechanisms due to endothelial injury and inflammatory response. The following article is the first reported case in Colombia of cerebral venous thrombosis in a previously healthy child, who debuted with gastrointestinal infectious disease and a week later with headache and sixth right cranial nerve palsy . The diagnosis of sagittal venous sinus thrombosis with extension to transverse sinuses was documented in a computed tomography angiography; laboratories for systemic diseases were negative and antibodies for coronavirus were positive.


Subject(s)
Humans , Male , Infant , Sinus Thrombosis, Intracranial , SARS-CoV-2 , COVID-19 , Thrombosis , Viruses , Coronavirus , Venous Thrombosis , Cranial Nerve Diseases , Transverse Sinuses , Headache
7.
Radiol. bras ; 54(5): 336-340, Sept.-Oct. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1340576

ABSTRACT

Abstract Vanishing bone metastasis (pseudopathological vertebral body enhancement) is a pitfall in the interpretation of contrast-enhanced computed tomography (CT) scans of patients with thoracic vein obstruction, mainly in the superior vena cava and brachiocephalic veins, typically being related to thrombosis due to malignant tumors. On the basis of the CT findings, pseudopathological vertebral body enhancement can be misdiagnosed as sclerotic bone metastasis, leading to unnecessary treatment. Although not rare, pseudopathological vertebral body enhancement is usually underdiagnosed by radiologists. The aim of this study is to review the pathophysiology of this phenomenon, illustrating the most common collateral venous pathways in thoracic vein obstruction and making the correlation with the CT findings.


Resumo Vanishing bone metastasis é um pitfall na tomografia computadorizada (TC) com contraste em pacientes com obstrução das veias torácicas, principalmente das veias cava superior e braquiocefálica, geralmente ocasionada por tumores malignos. Na TC, aparece como um realce pseudopatológico do corpo vertebral e pode ser erroneamente interpretado como metástase óssea esclerótica, levando a tratamento desnecessário. Embora não seja raro, esse achado geralmente é subdiagnosticado pelos radiologistas. O objetivo deste estudo é revisar a fisiopatologia desse fenômeno, ilustrando as vias venosas colaterais mais comuns na obstrução da veia torácica e correlacionar com os achados da TC.

8.
Arq. ciências saúde UNIPAR ; 25(3)set-out. 2021.
Article in Portuguese | LILACS | ID: biblio-1348200

ABSTRACT

Objetivo: Avaliar a prevalência dos fatores de risco e medidas de prevenção para trombose venosa profunda de pacientes cirúrgicos em Unidade de Terapia Intensiva. Métodos: Estudo transversal, conduzido em 2019, com utilização da escala de Caprini para classificação de cada paciente quanto ao risco para trombose venosa profunda, e análise das intervenções adotadas. Resultados: Foram avaliados 68 pacientes. Os fatores de risco mais prevalentes foram procedimento cirúrgico de grande porte (96%) e restrição ao leito (90%). O risco para tromboembolismo venoso foi alto (62/91%), moderado (5/7%) e baixo (1/2%). A mobilização de membros foi aplicada a todos os pacientes, deambulação precoce foi realizada em 62% e 56% foram submetidos à profilaxia medicamentosa. Conclusão: A alta prevalência dos fatores de risco para trombose venosa profunda em pacientes cirúrgicos e a baixa aplicabilidade de medidas preventivas demonstram a importância da implementação de programas de educação continuada e medidas de monitoramento desses eventos.


Objective: To assess the prevalence of the risk factors and preventive measures for deep venous thrombosis in surgical patients in the Intensive Care Unit. Methods: Cross-sectional study held in 2019 using the Caprini scale to classify each patient regarding their risk for deep venous thrombosis, and analysis of the actions taken. Results: A total of 68 patients were evaluated. The most prevalent risk factors were being submitted to major surgical procedures (96%) and bed restriction (90%). The risk for venous thromboembolism was high (62/91%), moderate (5/7%), and low (1/2%). Limb mobilization was applied on all patients; early ambulation was performed in 62%; and 56% were submitted to drug prophylaxis. Conclusion: The high prevalence of risk factors for deep vein thrombosis in surgical patients and the low applicability of preventive measures show the importance of implementing continuing education programs and measures to monitor such events.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Patients , General Surgery , Risk Factors , Venous Thrombosis/nursing , Intensive Care Units , Drug Prescriptions/nursing , Early Ambulation/nursing , Disease Prevention , Venous Thromboembolism/nursing , Ambulatory Care , Hospitalization , Nurses , Nursing Care
9.
Rev. cienc. med. Pinar Rio ; 25(3): e5038, 2021. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1289144

ABSTRACT

RESUMEN Introducción: el síndrome de Lemierre, describe a la flebotrombosis séptica de la vena yugular interna posterior a una infección orofaríngea. Esta enfermedad representa un verdadero reto diagnóstico para el médico practicante. Las complicaciones más temidas son las relacionadas con la embolización a distancia. Objetivo: describir la evolución clínica de una paciente con síndrome de Lemierre atendida en el Hospital Militar Central "Dr. Carlos J. Finlay". Caso Clínico: paciente femenina de 24 años de edad, con antecedentes de salud; 12 días antes del ingreso comenzó con fiebre de 39-40˚C, asociada a odinofagia y secreciones blanquecinas localizadas sobre ambas amígdalas. Tras recibir antibioticoterapia por vía oral percibe discreta mejoría. Luego de la cual recrudece la fiebre, aparece tos, disnea y dolor en punta de costado en el hemitórax derecho. Conclusiones: la evolución de la paciente fue satisfactoria luego del drenaje quirúrgico de la colección pleural, el uso de antibióticos específicos y la anticoagulación. La atención de pacientes con síndrome de Lemierre requiere asistencia especializada.


ABSTRACT Introduction: Lemierre's Syndrome (LS) describes septic phlebothrombosis of the internal jugular vein following oropharyngeal infection. This entity represents a real diagnostic challenge for the practicing physician. The most alarming complications are those related to distant embolization. Objective: to describe the clinical evolution of a patient with Lemierre's Syndrome treated at Dr. Carlos J. Finlay Central Military Hospital. Case Report: a 24-year-old female patient with a medical history; who 12 days before admission started with fever of 39-40˚C, associated with odynophagia and whitish secretions located over both tonsils. After receiving oral antibiotic therapy, she perceived a slight improvement. Subsequently fever intensified, cough, dyspnea and flank pain in the right hemithorax appear. Conclusions: the evolution of the patient was satisfactory after surgical drainage of the pleural collection, the use of specific antibiotics and anticoagulation. The care of patients with Lemierre's syndrome requires specialized assistance.

10.
Arq. bras. neurocir ; 40(1): 107-112, 29/06/2021.
Article in English | LILACS-Express | LILACS | ID: biblio-1362261

ABSTRACT

Neurofibromatosis type 1 (NF1) is a genetic syndrome which typically presents with neurological manifestations. Some of the patients may also present with vasculopathies, among which arterial aneurysms and stenosis are the most common. Deep vein thrombosis (DVT) has rarely been described, and, to the best of our knowledge, the present is the first report of DVT due to venous compression by a neurofibroma in the setting of NF1. This is the case of a 23-year-old male with NF1 who experienced DVT due to compression of the left posterior tibial veins by a large tumor arising from the tibial nerve. The DVT was acutely treated with enoxaparin and then with rivaroxaban. Two months after the diagnosis, Doppler ultrasonography showed partial recanalization and persistence of the DVT. The patient was then referred to neurosurgery for surgical resection of the tumor. There were no complications during the procedure, and the patient did not present postoperative neurological deficits. The final histopathological diagnosis was of a benign neurofibroma. After one year of follow-up with vascular surgery, the patient presented no more episodes of DVT. In case there is a tumor compressing the deep vessels of the leg and promoting DVT, surgical resection with microsurgical techniques may be curative.

11.
Säo Paulo med. j ; 139(3): 279-284, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1252247

ABSTRACT

ABSTRACT BACKGROUND: Vitamin D has relationships with pathogenesis and inflammation pathways in many diseases. Its deficiency may make clinicians think not only of supplementation but also of presence of other diseases. OBJECTIVE: To investigate the relationship between vitamin D levels and deep vein thrombosis (DVT), given that reduced levels are related to increased risk of cardiovascular diseases. DESIGN AND SETTING: Case-control study conducted in the cardiovascular surgery and family medicine departments of a hospital in Turkey. METHODS: A total of 280 participants were included: 140 each in the DVT and control groups. Basic clinical characteristics, comorbidities and serum 25-hydroxyvitamin D (25(OH)D) levels were recorded and then compared between the groups. Serum 25(OH)D levels were also evaluated separately in three subgroups (sufficient, insufficient and deficient). RESULTS: Serum 25(OH)D levels were significantly lower in the DVT group than in the controls (P < 0.001). Females in the DVT group had lower 25(OH)D levels than those in the control group (P = 0.002). Nonetheless, the median 25(OH)D level (16.41 ng/ml) of the control group was still below the reference value. Logistic regression analysis showed that 25(OH)D was a significant predictor of DVT. Weight, height and body mass index, which all presented interaction, were significant in the logistic regression analysis but not in individual analyses. CONCLUSION: The serum vitamin D levels of DVT patients were lower than those of controls. If the results obtained from our study are supported by further large-scale randomized controlled trials, vitamin D replacement may be brought into the agenda for protection against DVT.


Subject(s)
Humans , Male , Female , Vitamin D/blood , Vitamin D Deficiency/complications , Venous Thrombosis/etiology , Turkey , Case-Control Studies , Extremities
12.
Acta ortop. bras ; 29(1): 17-20, Jan.-Feb. 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1152726

ABSTRACT

ABSTRACT Objective: To report the incidence of deep vein thrombosis (DVT) in ipsilateral femur and tibial fractures (floating knee). Methods: This is a retrospective, analytical, observational study conducted with the medical records of thirty patients admitted to a trauma hospital between October 2016 and July 2017 with floating knee. Results: Patients aged between 21-30 years were the most affected by the condition (36%). Seventeen patients affected the dominant limb (57%); 19 (63%) patients were classified as Fraser type I, 18 (60%) had open (compound) fractures, 16 (53%) tibial fractures, and 8 (26%) femoral fractures. External fixation of the femur and tibia (25 patients = 83%) was the most common emergency treatment. In total, 17% of patients presented deep venous thrombosis (p = 0.409). Conclusion: Despite antithrombotic prophylaxis, the incidence of DVT in the affected limb of patients with floating knee was high. We found patients with Fraser I fractures, male, and with fractures in the non-dominant limb to present a higher chance of developing DVT. Level of Evidence III, Comparative retrospective study .


RESUMO Objetivo: Relatar a incidência de trombose venosa profunda (TVP) em fratura ipsilateral de fêmur e tíbia (joelho flutuante). Materiais e métodos: Realizado um estudo retrospectivo, observacional e analítico por meio da avaliação de prontuários de trinta pacientes admitidos com joelho flutuante em um hospital de trauma durante o período de outubro de 2016 a julho de 2017. Resultados: A faixa etária mais acometida foi entre 21 e 30 anos (36%). O acometimento do membro dominante ocorreu em 17 (57%) dos pacientes avaliados. Dezenove (63%) pacientes acometidos foram classificados como Fraser Tipo I. Dezoito (60%) pacientes tiveram fratura exposta, sendo 16 (53%) em tíbia e 8 (26%) em fêmur. O tratamento mais utilizado como urgência foi o de controle de danos com fixador externo em fêmur e tíbia (83%). Observamos trombose venosa profunda em 17% dos pacientes (p = 0,409). Conclusão: Apesar do uso da profilaxia antitrombótica medicamentosa, houve uma grande incidência de TVP no membro acometido em pacientes com joelho flutuante na população estudada. As fraturas classificadas como Fraser I, pacientes do sexo masculino e o membro não dominante levaram ao aumento da probabilidade do surgimento de TVP. Nível de Evidência III, Estudo retrospectivo comparativo.

13.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1340689

ABSTRACT

RESUMEN Introducción: Los trastornos vasculares son frecuentes en el Síndrome de Down (SD); sin embargo, no está claro si dichos pacientes tienen un mayor riesgo de eventos tromboembólicos venosos, lo que hace una asociación poco frecuente. Caso clínico: Se reporta el caso de una paciente del sexo femenino, adulto joven, de 27 años con SD que presentó un émbolo central de gran dimensión en la arteria pulmonar y su rama lobular media del lado derecho; asimismo, un trombo en la arteria femoral que taponaba casi completamente su diámetro, cuya presentación es asintomática; siendo diagnosticados por Angiotomografía y ecografía doppler correspondientemente. Se suministró como tratamiento Enoxaparina y Warfarina, teniendo una evolución favorable. Conclusión: Se debe prestar mucha atención a la correlación entre enfermedad tromboembólica venosa y síndrome de Down, y ampliar esfuerzo en su prevención, detección y tratamiento.


ABSTRACT Introduction: Vascular disorders are frequent in Down Syndrome (SD); however, it is unclear whether such patients are at increased risk for venous thromboembolic events, making this association rare. Clinical case: We report the case of a 27-year-old female patient with DS who presented a large central embolus in the pulmonary artery and its middle lobular branch on the right side; likewise, a thrombus in the femoral artery that almost completely blocked its diameter, whose presentation is asymptomatic; being diagnosed by CT Angiography and Doppler ultrasound accordingly. Enoxaparin and Warfarin were given as treatment, having a favorable evolution. Conclusion: Much attention should be paid to the correlation between venous thromboembolic disease and Down syndrome, and a wide effort should be made in its prevention, detection and treatment.

14.
Rev. neuropsiquiatr ; 84(1): 19-24, ene-mar 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1251973

ABSTRACT

RESUMEN Trombosis venosa cerebral (TVC) es una rara condición clínica caracterizada por una obstrucción de los senos venosos durales o de las venas corticales cerebrales que desencadena hipertensión intracraneal y síntomas tales como cefalea, crisis epilépticas y coma, entre otros. Se ha asociado como complicación neurológica del síndrome respiratorio agudo severo (SARS-CoV-2) del Coronavirus 2. Objetivo: Describir los casos reportados de TVC en pacientes con Enfermedad por Coronavirus 2019 (COVID-19). Material y Métodos: Se realizó una búsqueda bibliográfica en PubMed para recabar sólo los reportes de caso en los que los pacientes con COVID-19 desarrollaron TVC. Resultados: Se analizaron reportes de 13 pacientes y se recabó información sobre sexo, edad, comorbilidades, severidad del COVID-19, tipo de TVC, tratamiento recibido, complicaciones y desenlace final. Conclusión: TVC asociada a COVID-19 se puede presentar en pacientes con características variadas, suele tener complicaciones graves y en algunos casos, un desenlace mortal.


SUMMARY Cerebral venous thrombosis (CVT) is a rare clinical condition that consists of an obstruction of the dural venous sinuses or the cerebral cortical veins, triggering intracranial hypertension and symptoms such as headache, seizures and coma among others. CVT has recently been associated as a neurological complication of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Objective: To describe reported cases of CVT in patients with Coronavirus Disease 2019 (COVID - 19). Material and Methods: A literature search was conducted on PubMed to collect only case reports of patients with COVID-19 who developed CVT. Results: Report of 13 patients were analyzed and information was collected about sex, age, comorbidities, severity of COVID-19, type of CVT, treatments received, complications and the final outcome. Conclusion: CVT associated with COVID-19 can occur in patients with varied characteristics, often with serious complications and in some cases, a fatal outcome.

15.
Rev. colomb. cir ; 36(1): 98-109, 20210000. fig
Article in Spanish | LILACS | ID: biblio-1150524

ABSTRACT

La vena porta es un conducto que drena el flujo esplácnico al hígado y se puede ocluir por diferentes patologías, variando su presentación clínica de acuerdo con la causa de la obstrucción. Es muy importante diferenciar la trombosis portal asociada o no a la cirrosis, ya que su tratamiento y pronóstico es diferente. La trombosis venosa portal extrahepática es una condición netamente de origen vascular, y es la principal causa de trombosis portal en niños y adultos. Presentamos tres casos tratados con derivación meso-Rex, con seguimiento a 6 meses


The portal vein is a conduit that drains splanchnic flow to the liver, it can be occluded by different pathologies and its clinical presentation varies according to the cause of the obstruction. It is very important to differentiate portal thrombosis associated or not with cirrhosis, since its treatment and prognosis is different. Extrahepatic portal vein thrombosis (PEVT) is a condition of purely vascular origin, being the main cause of portal thrombosis in children and adults. We present three cases with meso-Rex shunt, with a 6-month follow-up


Subject(s)
Humans , Venous Thrombosis , Portal Vein , Varicose Veins , Portacaval Shunt, Surgical
16.
J. vasc. bras ; 20: e20210006, 2021. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1340182

ABSTRACT

Resumo A agenesia de veia cava inferior é descrita em menos de 1% da população, de ocorrência rara e devido a alterações embrionárias. Sua correlação com a trombose venosa profunda certamente é subestimada, visto que tal alteração é de difícil detecção pela ultrassonografia. O objetivo deste artigo foi relatar o caso de uma paciente de 41 anos com dor e edema até a raiz de coxa direita após cirurgia plástica. Foi realizado dúplex venoso de membros inferiores e evidenciada trombose venosa profunda ilíaco-femoro-poplíteo e distal bilateralmente. Solicitado angiotomografia venosa devido a não visualização de veia cava inferior no ultrassom, evidenciando trombose de plexo lombar direito e segmento ilíaco-femoral bilateral, além de agenesia de segmento infra-hepático de veia cava inferior, com ectasia e tortuosidade compensatória de veias paravertebrais, sistema ázigos e hemiázigos, com varizes pélvicas bilateralmente. Foi realizada anticoagulação sistêmica e oral, com boa evolução clínica.


Abstract Agenesis of the inferior vena cava (IVC) has been described in less than 1% of the population; a rare occurrence caused by embryonic abnormalities. Its correlation with deep vein thrombosis (DVT) is certainly underestimated, since this change is hard to detect using ultrasound. The aim of the article is to report the case of a 41-year-old female patient with pain and edema up to the top of the right thigh after plastic surgery. Bilateral venous duplex ultrasound revealed bilateral DVT involving iliac-femoral-popliteal and distal segments. Venous angiotomography was requested because the IVC was not visible on ultrasound, revealing thrombosis of the right lumbar plexus and iliofemoral segment bilaterally and agenesis of the infrahepatic segment of the inferior vena cava, with ectasia and compensatory tortuosity of paravertebral veins and the azygos-hemiazygos system, and bilateral pelvic varices. Systemic and oral anticoagulation were administered, with a satisfactory clinical response.

17.
J. vasc. bras ; 20: e20200133, 2021. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1287075

ABSTRACT

Resumo A síndrome de Budd-Chiari é uma doença venosa hepática rara, mais incidente em adultos jovens, podendo se apresentar na forma aguda, subaguda ou crônica, o que resulta em hipertensão portal. O tratamento tradicional consiste em técnicas de trombólise e de shunts portossistêmicos intra-hepáticos, como pontes para o transplante hepático. Recentemente, técnicas de angioplastia com balão ou stents têm sido relatadas para o tratamento dessa afecção. Neste artigo, é relatado e discutido um caso de síndrome de Budd-Chiari por obstrução membranosa da via de saída da veia supra-hepática com trombose da veia hepática média em uma paciente de 24 anos. O tratamento estabelecido foi a angioplastia transjugular com balão, que obteve resultados satisfatórios e boa evolução clínica.


Abstract The Budd-Chiari syndrome is a rare hepatic venous disease. It is more prevalent in young adults and may present in acute, subacute, or chronic forms, causing portal hypertension. Traditional treatment consists of thrombolysis techniques and transjugular intrahepatic portosystemic shunt, as a bridge to liver transplantation. Recently, use of balloon or stent angioplasty techniques has been reported for treatment of this condition. In this article, we report and discuss a case of BCS by membranous obstruction in the hepatic vein outflow tract, with middle hepatic vein thrombosis, in a 24-year-old patient. The treatment chosen and employed was transjugular balloon angioplasty, which achieved satisfactory results and good clinical evolution.

18.
J. vasc. bras ; 20: e20200036, 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1250235

ABSTRACT

Abstract Our study describes a fatal case of phlegmasia cerulea dolens and massive venous thrombosis in a patient taking rivaroxaban regularly to treat cerebral venous sinus thrombosis. Blood tests samples were positive for lupus anticoagulant. The unique evolution of the case, as well as the positivity for lupus anticoagulant, raises the possibility of an acquired hypercoagulation syndrome. We highlight the fact that the test recommended as the first line for lupus anticoagulant diagnosis (dilute Russell viper venom time) is the most affected by rivaroxaban, leading to a high prevalence of false-positive results. We also discuss potential diagnoses for the current case and review the current state-of-the-art of use of the novel oral anticoagulation agents in this unusual situation. So far, there are no recommendations to use such agents as first options in cerebral venous sinus thrombosis or in hypercoagulation syndromes.


Resumo Nosso estudo descreve um caso fatal de flegmasia cerúlea dolens e trombose venosa maciça em um paciente usando regularmente rivaroxabana para o tratamento de trombose de seio venoso cerebral. A investigação laboratorial foi positiva para o anticoagulante lúpico. A evolução única do caso aumenta a possibilidade de uma síndrome de hipercoagulabilidade adquirida, bem como a positividade para o anticoagulante lúpico. Destacamos o fato de que o teste recomendado como primeira linha para o diagnóstico de anticoagulante lúpico (veneno de víbora de Russel diluído) é o mais afetado pela rivaroxabana, levando a uma alta prevalência de resultados falso-positivos. Também discutimos os potenciais diagnósticos para o presente caso e revisamos o estado da arte atual dos novos agentes de anticoagulação oral usados nessa situação incomum. Até o presente momento, não há recomendações para o uso de tais agentes como primeira opção na trombose de seios venosos cerebrais ou nas síndromes de hipercoagulação.

19.
J. vasc. bras ; 20: e20200164, 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1250241

ABSTRACT

Resumo Com o aumento da duração e frequência das viagens aéreas, observou-se um aumento da prevalência de tromboembolismo venoso nos passageiros. Este estudo avaliou a eficácia do uso de meias elásticas de compressão graduada para a prevenção de tromboembolismo venoso desencadeado por viagens aéreas com duração maior que 3 horas de voo. Trata-se de uma revisão sistemática de ensaios clínicos. A qualidade metodológica dos estudos e o nível de evidência científica foram avaliados pelo Consolidated Standards of Reporting Trials e Grading of Recommendations Assessment, Development and Evaluation. Foram identificados 34 artigos, entretanto apenas oito atenderam aos critérios de elegibilidade. Os desfechos incidência de tromboembolismo venoso e edema foram avaliados em 2.022 e 1.311 passageiros, respectivamente. Os estudos demonstraram evidências de alta qualidade para a prevenção de edema e de moderada qualidade para a redução da incidência de tromboembolismo venoso com o uso de meias elásticas de compressão graduada durante viagens aéreas.


Abstract The increase in duration and frequency of flights has led to an increase in the prevalence of venous thromboembolism among airline passengers. This study assesses the efficacy of graduated compression stockings for prevention of venous thromboembolism triggered by flights lasting more than 3 hours. The design is a systematic review of clinical trials. The methodological quality of studies and the level of scientific evidence were evaluated using the Consolidated Standards of Reporting Trials and Grading of Recommendations Assessment, Development and Evaluation standards. A total of 34 articles were identified, but only eight met the eligibility criteria. The outcomes incidence of venous thromboembolism and edema were assessed in 2,022 and 1,311 passengers, respectively. The studies presented high quality evidence demonstrating prevention of edema and moderate quality evidence of reduced incidence of venous thromboembolism associated with wearing graduated compression stockings during flights.

20.
J. vasc. bras ; 20: e20200109, 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1250243

ABSTRACT

Resumo O tromboembolismo venoso (TEV) é uma das principais causas preveníveis de morbimortalidade em pacientes hospitalizados, sendo a embolia pulmonar (EP) fatal possivelmente a sua primeira manifestação. Diretrizes nacionais e internacionais recomendam o uso de modelos de avaliação de risco para a prescrição de profilaxia do TEV em pacientes hospitalizados. Apesar das evidências e diretrizes de apoio, o uso da tromboprofilaxia permanece abaixo do ideal, o que pode resultar da baixa conscientização dos benefícios da profilaxia, mas também pode refletir o medo de complicações hemorrágicas, justificando a subutilização da tromboprofilaxia em todo o mundo. A avaliação do risco de sangramento é, portanto, necessária para a adequação de profilaxia e deve ser realizada de forma concomitante à avaliação do risco de trombose. O objetivo desta revisão é salientar a importância da avaliação conjunta do risco de TEV e do risco de sangramento em pacientes hospitalizados.


Abstract Venous thromboembolism (VTE) is one of the main preventable causes of morbidity and mortality in hospitalized patients and fatal pulmonary embolism (PE) may be its first manifestation. Several national and international guidelines recommend using risk assessment models for prescription of VTE prophylaxis in hospitalized patients. Despite evidence and guidelines supporting VTE prevention, use of VTE prophylaxis in hospitalized patients remains suboptimal, which may be because of low awareness of the benefits of VTE prophylaxis, but might also reflect fear of bleeding complications in these patients, since this constitutes one of the main reasons for underutilization of thromboprophylaxis worldwide. Bleeding risk assessment is therefore necessary for adequate prophylaxis prescription and should be carried out concurrently with assessment of the risk of thrombosis. The purpose of this review is to highlight the importance of jointly assessing risk of VTE and risk of bleeding in hospitalized patients.

SELECTION OF CITATIONS
SEARCH DETAIL