Qualidade de vida em pacientes com doença arterial periférica / Quality of life in patients with peripheral artery disease

As doenças vasculares influenciam a qualidade de vida (QV) e afetam de forma direta o aspecto biopsicossocial dos indivíduos. Sendo assim, a QV é uma importante forma de avaliação das intervenções vasculares. Objetivo: Avaliar a QV em pacientes com doença arterial periférica internados no serviço de cirurgia vascular em um hospital terciário beneficente. Métodos: Trata-se de um estudo exploratório, com desenho transversal, em um serviço de cirurgia vascular em um hospital terciário beneficente, no qual pacientes com doença arterial periférica foram avaliados através de dois questionários, sendo um a respeito de qualidade de vida (versão abreviada WHOQOL-Bref) e outro sobre as condições sociodemográficas. Resultados: Foi observado que os domínios físico, meio ambiente e QV total obtiveram os menores escores entre os 127 entrevistados. Além disso, uma análise intragrupo demonstrou que os homens obtiveram pontuação maior em todos os domínios quando comparados às mulheres, com exceção do domínio de relações sociais. Conclusão: As mulheres com doença arterial periférica apresentaram uma menor pontuação em todos os domínios do questionário de QV, exceto no de relações sociais, quando comparadas aos homens.

Vascular diseases have a direct influence on quality of life (QoL) and directly affect patients' biopsychosocial aspects. Quality of life is therefore an important element for evaluation of vascular interventions. Objective: To assess QoL in inpatients with peripheral arterial disease at a vascular surgery service in a charitable tertiary hospital. Methods: This is an exploratory study, with a cross-sectional design, conducted at a vascular surgery service in a charitable tertiary hospital, assessing patients with peripheral arterial disease using two questionnaires, one on quality of life (the WHOQOL-Bref short form) and the other on sociodemographic conditions. Results: It was observed that the physical domain, environment domain and total QoL scores were the lowest for the whole sample of 127 interviewees. Additionally, an intragroup analysis showed that men scored higher in all domains when compared with women, with the exception of the social relationships domain. Conclusions: Women with peripheral arterial disease exhibited lower scores than men in all domains of the QoL questionnaire, except for social relationships.

Adventitial Cystic Disease of the Femoral Vein: a Case Report with the CT Venography

Fewer than 20 cases of adventitial cystic disease of the vein have been reported in the worldwide literature. This small number of reported cases may be due not only to the disease's low incidence, but also to the difficulty in making the proper diagnosis. Many techniques have been used to investigate this disease, but venography has been the traditional diagnostic tool. In this report we present a case of adventitial cystic disease that was well demonstrated by CT venography.

Acute arterial embolism of the lower extremities: impact of 24-hour duration on the outcome of management.

OBJECTIVE: Determine the impact of 24-hour duration of arterial embolism on the outcomes of management. MATERIAL AND METHOD: A prospective study of 91 patients with acute arterial embolism of the lower extremities was carried out. RESULTS: Among the 91 patients, 31(34.1%) were with early acute embolism(< 24 hours) and 60 (65.9%) were with late acute embolism (> 24 hours). Extensive limb gangrene was more common in patients with late acute embolism (26.7% versus 3.2%, p = 0.009). Subsequently, primary major amputation was higher in those patients (20% versus 3.2%, p = 0.05). In early acute embolism, surgical embolectomy was only the primary treatment of revascularization (87.1%) whereas in late acute embolism, there were varying modalities of revascularization (68.3%) in addition to surgical embolectomy. The successful revascularization after the initial surgical embolectomy was significantly higher in patients with early acute embolism (92.6% versus 43.9%, p < 0.001). Patients with late acute embolism had a higher tendency of undergoing major amputation after revascularization (24.4% versus 7.4%, p = 0.106). Successful outcome was higher in patients with early acute embolism (83.9% versus 58.3%, p = 0.014). CONCLUSION: The 24- hour duration of arterial embolism may be a crucial factor influencing the outcome in the management of this disease.

Fisiopatología y clínica del pie diabético / Pathophysiology and clinical features that involve the foot in diabetic patients

Emergencies that involve the foot in diabetic patients are a very common cause of morbidity. Ischemia is of prime importance but, in addition, neuropathy (with hypoesthesia) and sepsis are factors. Infections may follow minor trauma, or may be secondary, either to a long-standing ulcer or to an area of gangrene. The major importance of chronic ulcers of the feet, is that they are a portal of entry for infection. All these considerations are described in the article, with special considerations to the shoes employed and the stay.

Lesiones vasculares: aspectos epidemiológicos y tratamiento Hospital "Luis Razetti" Barinas estado Barinas / Vascular injuries: epidemiological aspects and treatment Hospital Dr. Luis Razetti, Barinas-estado Barinas

Evaluar los aspectos epidemiológicos y el manejo de las lesiones vasculares periféricas, abdominales y cervicales. Estudio retrospectivo, de corte transversal, descriptivo y analítico, de los pacientes con diagnóstico de lesiones vasculares intervenidos quirúrgicamente entre enero del 2001 a diciembre del 2005, en el Servicio de Cirugía del Hospital General Dr. "luis Razetti", Barinas, Estado Barinas. Un total de 71 pacientes fueron intervenidos de emergencia con diagnóstico de lesión vascular, siendo las más frecuentes las periféricas 57,74 por ciento (41 casos). La edad promedio fue 27,7 años predominio del sexo masculino. El mecanismo de lesión más frecuente fue por arma de fuego (43 casos). La presentación clínica usual fue hemorragia en el 40,8 por ciento de los casos y la complicación más frecuente fue edema con 23,94 por ciento, el porcentaje de amputación fue del 3,12 por ciento. El tratamiento quirúrgico más efectuado fue la reparación (injerto safeno o anastomosis primaria) en 23,94 por ciento y 16,9 por ciento, respectivamente. La mortalidad global fue del 25,5 por ciento; 83,3 por ciento de esta fue por causa de shock hipovolémico. Los traumatismos vasculares constituyen una emergencia quirúrgica, causa frecuente de mortalidad, que afecta predominantemente a pacientes en edad productiva. Es un problema complejo y desafiante que es atendido la mayoría de las veces por el cirujano general. Los centros hospitalarios deben contar con la infraestructura mínima para resolver estas lesiones, y de esta manera disminuir la morbi-mortalidad.

Doença vascuilar periférica / Peripheral vascular disease

A prevalência de diabete melito no Brasil é de 7,6 porcento e aumenta com a idade, atingindo 17,45 porcento da populaçäo da faixa etária de 60 a 69 anos. A doença arterial periférica atinge os pacientes nessa faixa etária e ocorre naqueles com maior duraçäo do diabete e que näo se controlam adequadamente. A doença oclusiva arterial é mais difusa nos diabéticos e atingepreferencialmente as artérias do segmento fêmoro-poplíteo-tibial, levando freqüentemente a amputaçäo. As manifestações clínicas säo a claudicaçäo intermitente e a isquemia crítica. As gangrenas isquêmicas quanto mais extensas e quanto mais proximais aumentam o risco de amputaçäo maior (transtibial ou transfemoral). Os métodos diagnósticos mais usados säo o Doppler-ultra-som, o eco-Doppler e a arteriografia. A arteriografia só é empregada para planejamento de restauraçäo arterial. O tratamento clínica consiste no controle dos fatores de risco de doença arterial obstrutiva, principalmente o controle da glicemia e o condicionamento físico nos diabéticos cuja queixa seja a claudicaçäo intemitente. A analgesia e a antibioticoterapia de amplo espectro säo indicados quando o paciente apresenta gangrenas. O tratamento cirúrgico compreende as restaurações arteriais, principalmente as pontes de safena (as angioplastias têm indicaçäo restritas), as simpatectomias, os debridamentos e as amputações. Toda ênfase da sobrevida limitada desses paciente, as restaurações arteriais, pois, apesar da sobrevida limitada desses pacientes, as restaurações arteriais permanecem pérvias por longo tempo em dois terços dos casos, é possível conservar 70 porcento dos membros comprometidos por um período de cinco anos, e doentes revascularizados apresentam melhor qualidade de vida e maior capacidade de deambulaçäo.

Exposiçäo ocupacional à vibraçäo transmitida através das mäos:uma revisäo sobre o distúrbio vascular periférico / Hand-transmitted vibration exposure:a review about the peripheric vascular disease

Trata das consequências da exposiçäo ocupacional à vibraçäo transmitida pelas mäos sobre a saúde do trabalhador

Digital vascular manifestations in SLE: a case report and review of literature for prognostic evaluation of cardiovascular manifestations in SLE

A young patient was seen at our Department of Vascular Surgery with secondary Raynaud's disease of a short duration, characterised by digital ischaemia of upper and lower limbs. Family history was positive. Investigations revealed presence of collagen disease. The most likely diagnosis was Systemic Lupus Erythematosus. The patient was treated with steroids and responded well by clinical [loss of symptoms and signs] and laboratory parameters [Falling ESR, lowered C3 and improved digital circulation on doppler flow studies]. Since the cardiovascular manifestations are prognostically important in the overall management, appropriate literature was reviewed and quoted here