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2.
Cad. Saúde Pública (Online) ; 37(5): e00033020, 2021. tab
Article in English | LILACS | ID: biblio-1278600

ABSTRACT

This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.


O estudo buscou investigar a associação entre consumo de frutas e verduras e placa carotídea (PC) e espessura íntima-média carotídea (EIMC), dois preditores de aterosclerose entre adultos das áreas urbana e rural com alto risco de desenvolver doenças cardiovasculares (DCVs) em uma região da China. Foram identificados 11.392 adultos com alto risco de DCV, entre 71.511 indivíduos da população geral, em um estudo transversal entre novembro de 2015 e maio de 2016 na Província de Jiangsu. Entre esses 11.392 participantes de alto risco, a prevalência de PC foi de 36,7%. As variáveis independentes, ou seja, frequências de consumo de frutas e verduras, foram avaliadas através de um questionário de frequência alimentar. As variáveis de desfecho, EIMC e PC, foram medidas por ultrassom. A análise ANCOVA não mostrou associação entre valores de EIMC e frequências de consumo de frutas e verduras. Foram introduzidos modelos de regressão logística multivariada para examinar a associação entre consumo de frutas e verduras e PC. Depois de ajustar para potenciais fatores de confusão, as ORs para participantes com consumo eventual e diário de verduras para qualquer PC foram 0,67 (IC95%: 0,58-0,78) e 0,70 (IC95%: 0,62-0,79), respectivamente, comparado com aqueles com consumo raro de verduras. Enquanto isso, as ORs ajustados foram 0,77 (IC95%: 0,64-0,92) e 0,80 (IC95%: 0,68-0,94), separadamente, para adultos com consumo eventual e diário de verduras para desenvolver uma PC única, comparado aos que relatavam consumo raro de verduras. Entretanto, não foi observada uma associação significativa entre consumo de frutas e PC. Entre a população chinesa com alto risco de DCV, o consumo de verduras frescas mostrou associação negativa com o risco de desenvolvimento de placa carotídea.


El objetivo de este estudio fue investigar la asociación del consumo de frutas y verduras con la placa carotídea (PC) y el grosor íntima-media carotídeo (GIMC), dos predictores de la aterosclerosis carotídea en adultos urbanos y rurales, con alto riesgo de desarrollar enfermedades cardiovasculares (ECV) en una región de China. Se identificaron, en este estudio transversal, a 11.392 adultos con alto riesgo de ECV dentro de una población general de 71.511, realizado entre noviembre de 2015 y mayo de 2016 en la provincia de Jiangsu. De estos 11.392 participantes en alto riesgo, la prevalencia de PC fue de un 36,7%. Las variables independientes, así como la frecuencia de consumo de verduras y fruta, se evaluaron mediante un cuestionario de frecuencia de comidas. Las variables de resultado, GIMC y PC, se midieron por un examen de ultrasonido. El análisis ANCOVA mostró que no existía asociación entre los valores GIMC y la frecuencia en el consumo de verduras y frutas. Los modelos de regresión logística multivariantes se introdujeron para examinar la asociación entre el consumo de verduras y frutas y la PC. Tras el ajuste para los factores potenciales de confusión, las ORs de haber tenido alguna PC para los participantes que ocasionalmente y diariamente consumían verduras fueron 0,67 (IC95%: 0,58-0,78) y 0,70 (IC95%: 0,62-0,79), respectivamente, comparadas con quienes raramente consumían verduras. Mientras que las ORs ajustadas fueron 0,77 (IC95%: 0,64-0,92) y 0,80 (IC95%: 0,68-0,94), separadamente, para los consumidores ocasionales y los consumidores diarios de verduras de desarrollar una única PC, en relación con sus contrapartes que raramente consumían verduras. No obstante, no se observó una asociación significativa entre el consumo de frutas y la PC. Entre la población con alto riesgo de ECV, el consumo de verdura fresca estuvo negativamente asociado con el riesgo de desarrollar PC.


Subject(s)
Humans , Adult , Vegetables , Carotid Artery Diseases/etiology , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/diagnostic imaging , Brazil , China/epidemiology , Cross-Sectional Studies , Diet , Carotid Intima-Media Thickness , Fruit
3.
J. oral res. (Impresa) ; 9(6): 511-515, dic. 31, 2020. ilus
Article in English | LILACS | ID: biblio-1178949

ABSTRACT

Introduction: Atherosclerosis is a progressive inflammatory disease that can trigger serious medical consequences like acute myocardial infarction or stroke. Case Report: The purpose of this study is to report an unusual case of finding calcified atheromatous plaques in the carotid arteries bilaterally using a panoramic radiography (PR). A 75-year-old female with a morbid history, attends the Teaching Dental Clinic of the Pontifical Catholic University with complementary exams. PR showed well-defined radiopaque structures adjacent to C4. Using a Doppler ultrasound, the presence of calcified atheromas in the right and left carotid arteries were confirmed. The patient was informed of these findings and is currently under medical follow-up. Conclusion: PR is a useful complementary resource in the detection of atherosclerotic plaques of the upper carotid region.


Introducción: La aterosclerosis es una enfermedad inflamatoria progresiva que puede desencadenar graves consecuencias médicas como infarto agudo de miocardio o accidente cerebrovascular. Case Report: El propósito de este estudio es reportar un caso inusual de hallazgo de placas ateromatosas calcificadas en las arterias carótidas de forma bilateral mediante una radiografía panorámica. Mujer de 75 años con antecedentes mórbidos, acude a la Clínica Odontológica Docente de la Pontificia Universidad Católica con exámenes complementarios. La radiografía panorámica mostró estructuras radiopacas bien definidas adyacentes a C4. Mediante ecografía Doppler se confirmó la presencia de ateromas calcificados en las arterias carótidas derecha e izquierda. El paciente fue informado de estos hallazgos y actualmente se encuentra en seguimiento médico. Conclusión: La radiografía panorámica es un recurso complementario útil en la detección de placas ateroscleróticas de la región carotídea superior.


Subject(s)
Humans , Female , Aged , Radiography, Panoramic , Carotid Artery Diseases/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Ultrasonography , Stroke , Atherosclerosis/complications , Plaque, Atherosclerotic , Infarction
4.
Int. j. morphol ; 38(6): 1560-1565, Dec. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1134478

ABSTRACT

RESUMEN: Aunque la radiografía panorámica no es una prueba de diagnóstico inicial para detectar la aterosclerosis carotídea, no podemos ignorar su valor al ver estas lesiones como hallazgos incidentales que pueden ser grandes aliados en el diagnóstico temprano y la prevención de eventos vasculares graves. El objetivo de este estudio fue evaluar la prevalencia de calcificaciones en la bifurcación de la arteria carótida en las radiografías panorámicas de rutina como principio diagnóstico, así como su relación con los factores de riesgo cardiovascular en individuos brasileños. Se analizaron 449 exámenes de radiografía panorámica de la base de datos del Departamento de Radiología de la Facultad de Odontología de Piracicaba, UNICAMP, São Paulo, Brasil. Después de obtener mediciones de la presión arterial e información sobre el tabaquismo y las enfermedades sistémicas, fue buscado en la radiografía panorámica la presencia o ausencia de la masa radiopaca en las regiones de las vértebras cervicales C3-C4. En el caso de una imagen sugestiva de ateroma, se realizó una radiografía anteroposterior para confirmar el diagnóstico. Aplicamos la prueba estadística de Chi-cuadrado con distribución normal y muestras independientes y aleatorias con un intervalo de confianza del 95 %. La confirmación de calcificaciones carotideas se produjo en el 8,5 % de la población de estudio (38 casos). No encontramos ninguna relación entre la presencia de calcificaciones con el tabaquismo, con el sexo o con datos previos de antecedentes familiares. Sin embargo 49,1 % de los casos estaban por encima de sesenta años y tenía asociación significativa con la hipertensión (P = 0,006). El mayor riesgo se presenta en pacientes ancianos hipertensos y, por lo tanto, hacemos hincapié en la importancia de una observación minuciosa de las radiografías panorámicas en la búsqueda de cualquier alteración de la anatomía normal y si es así, proceder con la derivación lo antes posible para un diagnóstico concluyente por parte de un especialista, pudiendo así ayudar en la prevención de episodios vasculares graves.


SUMMARY: Although panoramic radiography is not an initial diagnostic test for detecting carotid atherosclerosis, we cannot ignore its value in viewing these lesions as incidental findings that can be great allies in early diagnosis and prevention of serious vascular events. The aim was to evaluate the prevalence of calcifications in the bifurcation of the carotid artery on routine panoramic radiographs as a diagnostic principle, as well as its relationship with cardiovascular risk factors in Brazilians. We analyzed 449 panoramic radiography exams from the database of the Department of Radiology of the Faculty of Dentistry of Piracicaba, UNICAMP, São Paulo, Brazil. After obtaining blood pressure measurements and information on smoking and systemic diseases, the researcher observed on the panoramic radiograph, the presence or absence of the radiopaque mass in the regions of the cervical vertebrae C3-C4. In the case of a suggestive image of atheroma, an anteroposterior radiography was performed to confirm the diagnosis. The Chi-square test of normal distribution for independent and random samples with a 95 % confidence interval was applied to the data. Confirmation of carotid calcifications occurred in 8.5 % of the study population (38 cases). We did not find any relationship between the presence of calcifications with smoking, sex or previous family history. However, 49.1 % of cases occurred above sixty years old and there was a significant relationship with hypertension (P = 0.006). The greatest risk was presented in elderly and hypertensive patients, so we highlight the importance of a thorough observation by the dentist of panoramic radiographs to detect any alteration of the normal anatomy and in the positive case, proceed with the referral as soon as possible for a conclusive diagnosis by a specialist, being able to thus assist in the prevention of severe vascular episodes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiovascular Diseases/epidemiology , Carotid Arteries/pathology , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/diagnostic imaging , Brazil/epidemiology , Calcinosis/diagnostic imaging , Radiography, Panoramic , Cardiovascular Diseases/etiology , Carotid Arteries/diagnostic imaging , Carotid Artery Diseases/complications , Chi-Square Distribution , Confidence Intervals , Prevalence , Retrospective Studies , Risk Factors , Atherosclerosis/diagnostic imaging , Hypertension
5.
Arq. bras. cardiol ; 114(6): 1004-1012, Jun., 2020. tab, graf
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131236

ABSTRACT

Resumo Fundamento A doença arterial coronariana (DAC) associada à quimioterapia está se tornando um tema emergente na prática clínica. Contudo, o mecanismo subjacente da quimioterapia associada à DAC permanence incerto. Objetivos O estudo investigou a associação entre a quimioterapia e as anomalias anatômicas ateroscleróticas das artérias coronárias dentre pacientes com cancer de pulmão. Métodos Foram incluídos pacientes submetidos à angiografia coronária (AGC), entre 2010 e 2017, com câncer de pulmão prévio. Os fatores de risco associados à DAC e os dados sobre o câncer de pulmão foram avaliados. Avaliamos as anomalias das artérias coronárias de acordo com o escore SYNTAX (SXescore) calculado à AGC. Na análise de regressão logística, o escore SYNTAX foi classificado como alto (SXescoreALTO) se ≥22. Os dados foram analisados através de estatística descritiva e análise de regressão. Resultados Ao todo, 94 pacientes foram incluídos no estudo. O SXescore foi mais alto no grupo com quimioterapia quando comparado com o grupo sem quimioterapia (25,25, IIQ [4,50-30,00] versus 16,50, IIQ [5,00-22,00]; p = 0,0195). A taxa do SXescoreALTO foi maior no grupo com quimioterapia do que no no grupo sem quimioterapia (58,33% versus 25,86; p = 0,0016). Tanto a análise de regressão logística univariada (OR: 4,013; 95% IC:1,655-9,731) quanto a multivariada (OR: 5,868; 95% IC:1,778-19,367) revelaram que a quimioterapia aumentou o risco de uma maior taxa do SXescoreALTO. A análise multivariada de regressão logística Stepwise mostrou que o risco para DAC anatômica mais grave aumenta com a quimioterapia como um todo em 5.323 vezes (95% IC: 2,002-14,152), e com o regime à base de platina em 5,850 vezes (95% IC: 2,027-16,879). Conclusões A quimioterapia está associada com a complexidade e gravidade anatômica da DAC, o que pode explicar, em parte, o maior risco de DAC associada à quimioterapia dentre pacientes com câncer de pulmão. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Abstract Background Chemotherapy-related coronary artery disease (CAD) is becoming an emerging issue in clinic. However, the underlying mechanism of chemotherapy-related CAD remains unclear. Objective The study investigated the association between chemotherapy and atherosclerotic anatomical abnormalities of coronary arteries among lung cancer patients. Methods Patients undergoing coronary angiography (CAG) between 2010 and 2017, who previously had lung cancer, were examined. Risk factors associated with CAD and information about lung cancer were evaluated. We assessed coronary-artery abnormalities by SYNTAX score (SXscore) based on CAG. In logistic-regression analysis, we defined high SXscore (SXhigh) grade as positive if ≥22. Data were analyzed through descriptive statistics and regression analysis. Results A total of 94 patients were included in the study. The SXscore was higher in the chemotherapy group than in the non-chemotherapy group (25.25, IQR [4.50-30.00] vs. 16.50, IQR [ 5.00-22.00], p = 0.0195). The SXhigh rate was greater in the chemotherapy group than in the non-chemotherapy group (58.33% vs. 25.86; p = 0.0016). Both univariate (OR:4.013; 95% CI:1.655-9.731) and multivariate (OR:5.868; 95% CI:1.778-19.367) logistic-regression analysis revealed that chemotherapy increased the risk of greater SXhigh rates. Multivariate stepwise logistic-regression analysis showed the risk of more severe anatomical CAD is increased by chemotherapy as a whole by 5.323 times (95% CI: 2.002-14.152), and by platinum-based regimens by 5.850 times (95% CI: 2.027-16.879). Conclusions Chemotherapy is associated with anatomical complexity and severity of CAD, which might partly account for the higher risk of chemotherapy-related CAD among lung cancer patients. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Subject(s)
Coronary Artery Disease/chemically induced , Carotid Artery Diseases/diagnostic imaging , Coronary Angiography/methods , Coronary Vessels/diagnostic imaging , Lung Neoplasms/drug therapy , Antineoplastic Agents/adverse effects , Severity of Illness Index , Risk Factors , Ultrasonography, Doppler, Color , Antineoplastic Agents/administration & dosage
7.
Braz. j. med. biol. res ; 52(7): e8432, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011590

ABSTRACT

Peripheral arterial disease (PAD) can impair healing of diabetic foot (DF) in patients with diabetes mellitus. To determine whether carotid intima-media thickness (CIMT) can predict lower limb arterial lesions in patients with DF, this cross-sectional study enrolled patients with DF at West China Hospital (China) between January 2012 and December 2015. Ultrasonography was used to measure CIMT, assess the internal carotid arteries (ICA) for plaques, and evaluate lower limb segmental arteries for stenosis. The optimal CIMT cutoff for detecting lower limb PAD was determined by receiver operating characteristic (ROC) curve analysis. Factors associated with PAD were identified by logistic regression analyses. A total of 167 patients (mean age: 69.7±10.3 years; 102 men) were included. Patients with PAD were older and had higher levels of total cholesterol and low-density lipoprotein than patients without PAD (P<0.05). The area under the ROC curve was 0.747 (P<0.001). At the optimal CIMT cutoff of 0.71 mm, the sensitivity, specificity, positive predictive value, and negative predictive value were 79.65, 61.11, 81.08, and 58.93%, respectively. Compared with those without PAD, more patients with PAD had CIMT ≥0.71 mm (79.65 vs 38.89%; P<0.001) and ICA plaques (66.37vs 11.11%; P<0.001). Multivariate logistic regression revealed that age (odds ratio [OR]: 1.118; 95% confidence interval [95%CI]: 1.056-1.183; P<0.001), ICA plaques (OR: 13.452; 95%CI: 4.450-40.662; P<0.001), and CIMT ≥0.71 mm (OR: 2.802; 95%CI: 1.092-7.188; P=0.032) were associated with PAD.CIMT may be a surrogate marker of PAD in patients with DF.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carotid Artery Diseases/complications , Diabetic Foot/etiology , Lower Extremity/blood supply , Carotid Intima-Media Thickness/adverse effects , Carotid Artery Diseases/pathology , Carotid Artery Diseases/diagnostic imaging , Cross-Sectional Studies , Predictive Value of Tests , Prospective Studies , Lower Extremity/pathology
9.
Arq. bras. oftalmol ; 81(2): 148-152, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-950435

ABSTRACT

ABSTRACT Differentiating glaucomatous from nonglaucomatous optic disc cupping remains challenging. We present a case of a 48-year-old woman with an internal carotid aneurysm of approximately 3.5 mm × 6.5 mm that mimicked normal-tension glaucoma. The patient had a 2-year history of low vision acuity in her left eye and frontal oppressive headache. Owing to the carotid aneurysm, she developed an asymmetric vertical cup-to-disc ratio above 0.2, and marked inferotemporal neuronal rim loss and pallor of the residual rim were noted in the left disc. She also developed a visual field defect with an arcuate scotoma in the left eye. The patient was referred to a neurosurgeon and underwent endovascular aneurysm occlusion. This case highlights the diagnostic importance of recognizing that many neurological defects remain underdiagnosed.


RESUMO diferenciação de escavações glaucomatosas e não glaucomatosas ainda permanece um desafio ainda nos dias de hoje. Nos descrevemos um caso de aneurisma de carótida interna medindo 3.5mm x 6.5mm que simulava um glaucoma de pressão normal. O caso é sobre uma paciente feminino de 48 anos com história de 2 anos de baixa acuidade visual no olho esquerdo e cefaléia frontal. Devido ao aneurisma de carótida a paciente desenvolveu uma assimetria de escavação vertical maior que 0.2 no olho esquerdo em relação ao direito com defeito localizado da camada de fibras nervosas temporal inferior. Ela também apresentava um defeito arqueado temporal superior a esquerda, cruzando a linha média vertical consistente. Após o diagnostico confirmado pela ressonância magnética funcional, a paciente foi enviada para o neurocirurgião para realização de uma oclusão endovascular do aneurisma. Esse caso nos alerta da importância de se lembrar que não apenas o glaucoma gera escavações suspeitas no disco óptico e que ainda muitos defeitos por causas neurológicas são subdiagnosticados.


Subject(s)
Humans , Female , Middle Aged , Carotid Artery Diseases/diagnostic imaging , Carotid Artery, Internal/diagnostic imaging , Low Tension Glaucoma/diagnostic imaging , Aneurysm/diagnosis , Retina/diagnostic imaging , Magnetic Resonance Imaging/methods , Carotid Artery Diseases/physiopathology , Carotid Artery Diseases/pathology , Carotid Artery, Internal/physiopathology , Carotid Artery, Internal/pathology , Diagnosis, Differential , Low Tension Glaucoma/physiopathology , Low Tension Glaucoma/pathology , Visual Field Tests , Intraocular Pressure
10.
Arq. neuropsiquiatr ; 75(7): 429-432, July 2017. tab
Article in English | LILACS | ID: biblio-888296

ABSTRACT

ABSTRACT The circle of Willis is an important collateral system that maintains perfusion to the stenotic area from the contralateral carotid and basilar artery to the region of reduced brain perfusion. The aim of the present study was to compare the circle of Willis anomaly in patients with unilateral symptomatic and asymptomatic carotid artery disease. Results In this retrospective study, we analyzed 175 patients who presented at our outpatient stroke clinic between January, 2013 and June, 2015 with either unilateral symptomatic or asymptomatic carotid artery disease, and who had had CT angiography imaging performed. Demographic properties, carotid artery stenosis and the anomaly of the circle of Willis was recorded. Conclusion There was no statistically significant difference in patients with symptomatic and asymptomatic carotid artery disease in terms of the anomaly of the circle of Willis.


RESUMO O Círculo de Willis é um importante sistema colateral que mantém a perfusão à área estenótica da carótida contralateral e da artéria basilar para a região de perfusão cerebral reduzida. O objetivo do presente estudo foi comparar a anomalia do Círculo de Willis em pacientes com doença carotídea assintomática e sintomática unilateral. Resultados Neste estudo retrospectivo, foram analisados 175 pacientes que foram à nossa clínica ambulatorial de AVC, entre janeiro de 2013 e junho de 2015, com doença carotídea assintomática ou sintomática unilateral, e que fizeram angiografia por tomografia computadorizada. Propriedades demográficas, estenose da artéria carótida e anomalia do Círculo de Willis foram registradas. Conclusão Não houve diferença estatisticamente significativa em pacientes com doença carotídea sintomática e assintomática em termos de anomalia do Círculo de Willis.


Subject(s)
Humans , Male , Female , Middle Aged , Carotid Artery Diseases/complications , Circle of Willis/abnormalities , Stroke/etiology , Carotid Artery Diseases/diagnostic imaging , Retrospective Studies , Risk Factors , Circle of Willis/diagnostic imaging , Stroke/diagnostic imaging , Computed Tomography Angiography
11.
Arq. bras. cardiol ; 108(1): 3-11, Jan. 2017. tab, graf
Article in English | LILACS | ID: biblio-838673

ABSTRACT

Abstract Background: The prevalence of atherosclerosis is higher in HIV-positive people, who also experience it earlier than the general population. Objectives: To assess and compare the prevalence of atherosclerosis evaluated by the intima-media thickness of carotid and femoral arteries, and by the ankle-brachial pressure index (ABPI) in HIV patients treated or not treated with protease inhibitors (PIs) and controls. Methods: Eighty HIV+ subjects (40 using PIs and 40 not using PIs) and 65 controls were included in the study. Atherosclerosis was diagnosed by (carotid and femoral) ITM measurement and ABPI. Classical risk factors for atherosclerosis and HIV were compared between the groups by statistical tests. A p ≤ 0.05 was considered significant. Results: An IMT > P75 or the presence of plaque was higher in the HIV+ than in the control group (37.5% vs 19%, p = 0.04). Comparative analysis showed a significant difference (p=0.014) in carotid IMT between HIV+ with PIs (0.71 ± 0.28 mm), without PIs 0.63 ± 0.11 mm and, and controls (0.59 ± 0.11 mm). There was no significant difference in femoral IMT between the groups or in ABPI between HIV+ subjects and controls. However, a significant difference (p=0.015) was found between HIV+ patients not treated with PIs (1.17 [1.08 - 1.23]), and controls 1.08 [1.07 - 1.17]). Conclusion: In HIV patients, atherosclerosis is more prevalent and seems to occur earlier with particular characteristics compared with HIV-negative subjects.


Resumo Fundamento: Pessoas que vivem com o HIV (HIV +) têm maior prevalência de aterosclerose e a desenvolvem mais precocemente do que a população geral. Objetivos: Foi avaliar e comparar as prevalências de aterosclerose avaliada pela medida da espessura mediointimal (EMI) das carótidas comuns e femorais, e do índice tornozelo-braquial (ITB) nos grupos controle e HIV com e sem inibidores de protease (IPs). Métodos: Foram incluídas 80 pessoas com HIV + [40 usavam IPs e 40 não] e 65 controles. O diagnóstico de aterosclerose foi determinado pela medição da EMI (carótidas e femorais) e do ITB. Fatores de risco clássicos para aterosclerose e específicos para o HIV foram comparados entre os grupos, usando testes estatístcos. O valor de p ≤ 0,05 foi cosiderado significativo. Resultados: A EMI > P75 ou presença de placa foi mais elevada no grupo de HIV sem IP que no controle (37,5% vs 19%, p = 0,04). A análise comparativa mostrou diferença significativa (p=0,014) na EMI nas artérias carótidas entre HIV + com IPs (0,71 ± 0,28 mm), sem IPs (0,63 ± 0,11 mm) e controles (0,59 ± 0,11 mm), A EMI na femoral não teve diferença significante entre os grupos. Não houve diferença significante entre os grupos controle e de HIV + quanto ao ITB. No entanto, observou-se uma diferença significativa (p=0,015) no ITB entre os grupos HIV + sem IPs (1,17 [1,08 - 1,23]), e controles [1,08 (1,07 - 1,17)]. Conclusão: Em pacientes com HIV, a aterosclerose é mais prevalente e parece ocorrer mais precocemente, com características distintas, em comparação a indivíduos HIV-negativos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Arteriosclerosis/epidemiology , Arteriosclerosis/diagnostic imaging , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/diagnostic imaging , Acquired Immunodeficiency Syndrome/epidemiology , Carotid Intima-Media Thickness , Arteriosclerosis/etiology , Reference Values , Brazil/epidemiology , Carotid Artery Diseases/etiology , Carotid Artery Diseases/pathology , Case-Control Studies , Prevalence , Cross-Sectional Studies , Prospective Studies , Risk Factors , Sensitivity and Specificity , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/drug therapy , Statistics, Nonparametric , CD4 Lymphocyte Count , Antiretroviral Therapy, Highly Active , Ankle Brachial Index , Femoral Artery/diagnostic imaging
12.
J. vasc. bras ; 15(4): 302-307, Oct.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-841385

ABSTRACT

Abstract Carotid artery disease has been linked with cerebral vascular accident, also known as stroke, cerebral hemorrhage, or cerebral ischemia. It is caused by narrowing or obstruction of arteries in the neck (the carotid arteries) that are responsible for transporting blood from the aorta to the brain. Panoramic radiographs are used in dentistry to show both dental arches as a supplement to the clinical dental examination. The objective of this study is to highlight the importance of panoramic radiographs for diagnosis of arterial disease, by means of a bibliographic review. The PubMed database was searched using the keywords “atherosclerosis” and “panoramic”, with the filters “last 5 years” and “humans”. Twenty articles were identified, six of which were chosen for this study because they were open access. The review concluded that panoramic radiographs enable early diagnosis of carotid artery calcification, resulting in earlier interventions, and offer an accessible cost.


Resumo Doenças das artérias carótidas estão associadas a casos de acidente vascular cerebral, também chamados de derrame ou isquemia cerebral. Ocorrem devido ao estreitamento ou obstrução das artérias do pescoço, ou artérias carótidas, responsáveis por levar o sangue da aorta para o cérebro. A radiografia panorâmica é um exame de ambos os arcos dentários que ajuda no exame clínico odontológico. Destacar a importância da radiografia panorâmica no diagnóstico de doença arterial é o objetivo deste trabalho, que foi realizado através de pesquisa bibliográfica na PubMed, com as palavras-chave “atherosclerosis” e “panoramic”, e os filtros: últimos 5 anos e humanos. Vinte artigos foram elencados, dos quais seis formaram a base para este estudo, graças ao acesso livre ao seu conteúdo. Conclui-se que a radiografia panorâmica permite o diagnóstico precoce de calcificação da artéria carótida, levando a uma intervenção precoce a um custo acessível.


Subject(s)
Humans , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/prevention & control , Dental Arch/diagnostic imaging , Dentistry , Radiography, Panoramic/history , Coronary Angiography/history
13.
Ciênc. saúde coletiva ; 21(7): 2201-2208, Jul. 2016. tab, graf
Article in English | LILACS | ID: lil-785900

ABSTRACT

Abstract Panoramic radiographs (PR) can display radiopaque images suggestive of calcified atheroma in the carotid artery in asymptomatic patients. The aim of this study was to evaluate the prevalence of these images on PR and their linkage with hypertension, obesity, age, gender and smoking habits. PR of 505 patients were evaluated. They were older than 30 years old and their PR had been taken for different clinical reasons. Their body mass index was calculated; their waist circumference was also taken into consideration. Information about smoking habits and hypertension was obtained. The observers analyzed the presence of radiopaque mass in the region of the cervical vertebrae C3-C4 through the PR, confirmed by an antero-posterior (AP) radiograph. The results showed a 7.92% prevalence of suggestive images of calcifications on PR and on AP radiograph. The adjusted Odds Ratio showed association with age and smoking habits. The calcification process is almost nine times higher for the elderly when compared to the young. As far as smokers are concerned, this process is twice worse when compared to no smokers. In conclusion, 7.92% of the group studied presented suggestive images of carotid atherosclerosis on PR, which is directly associated with the age and smoking habits.


Resumo As radiografias panorâmicas (RP) podem exibir imagens radiopacas sugestivas de ateromas calcificados na artéria carótida em pacientes assintomáticos. O objetivo deste estudo foi avaliar a prevalência destas imagens na RP e sua relação com hipertensão, obesidade, idade, sexo e tabagismo. Foram avaliadas RP de 505 pacientes acima de trinta anos, que realizaram esse exame por diversos motivos clínicos. Seu índice de massa corpórea foi calculado; sua circunferência abdominal também foi considerada. Informações sobre hipertensão e tabagismo foram obtidas. Os observadores avaliaram as RP para a presença de massas radiopacas na região das vértebras cervicais C3-C4, confirmadas por meio de uma radiografia ântero-posterior (AP). Os resultados mostraram prevalência de 7,92% de imagens sugestivas de calcificações em RP e na radiografia AP. A razão de probabilidade (OR) ajustada mostrou associação com idade e tabagismo. O risco para as pessoas mais velhas aumenta até cerca de nove vezes quando comparado com aqueles mais jovens, enquanto para os fumantes, o risco é o dobro, quando comparado com não fumantes. Na população estudada, 7,92% de todos os sujeitos apresentaram imagens sugestivas de aterosclerose carotídea em RP e houve associação com idade e tabagismo.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/epidemiology , Carotid Artery Diseases/etiology , Vascular Calcification/diagnostic imaging , Vascular Calcification/epidemiology , Vascular Calcification/etiology , Angiography/methods , Cardiovascular Diseases/complications , Causality , Hypertension/complications , Obesity/complications , Prevalence , Radiography, Panoramic , Sex Factors , Smoking/adverse effects
14.
Rev. méd. Chile ; 144(1): 30-38, ene. 2016. graf, tab
Article in Spanish | LILACS | ID: lil-776972

ABSTRACT

Background: Framingham risk score (FRS) has limitations and can underestimate risk. Carotid ultrasound to measure intima media thickness or plaques is recommended for cardiovascular risk assessment. Aim: To determine the prevalence of subclinical atherosclerosis in asymptomatic subjects classified as low and intermediate risk. Material and Methods: Cross-sectional study performed in subjects without cardiovascular disease. Cardiovascular risk was estimated using the Chilean FRS and the General Cardiovascular Disease FRS. Carotid ultrasound was performed in all subjects. We defined subclinical atherosclerosis as the presence of carotid plaque or intima media thickness greater than 75th percentile by gender and age. Results: We studied 203 subjects aged 47.2 ± 9.6 years (54% males). Mean intima media thickness was 0.62 ± 0.1 mm. An abnormal value was detected in 68 subjects (33%) and carotid plaques in 32 subjects (15.7%). Based on Chilean FRS, 96% were considered at low risk, 4% at intermediate, and none at high risk. In the low risk group the prevalence of abnormal intima media thickness and plaques was 40 and 14% respectively. Presence of plaques was more common in women than men (23 and 7% respectively, p < 0.01). According to the General Cardiovascular Disease FRS, 23% were at low, 39% at low intermediate and 28% at high intermediate risk. In the low risk group the prevalence of an abnormal intima media thickness was 34% and no subject had plaques. Conclusions: Carotid plaques were detected in Chilean subjects classified as having a low FRS risk. The underestimation of risk was higher in Chilean women.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Carotid Artery Diseases/complications , Carotid Artery Diseases/diagnostic imaging , Carotid Intima-Media Thickness , Chile/epidemiology , Sex Factors , Prevalence , Cross-Sectional Studies , Risk Factors , Risk Assessment
15.
Article in English | IMSEAR | ID: sea-154533

ABSTRACT

Objectives: The objective of this study was to determine whether digital panoramic radiography is a reliable method to detect calcified carotid artery atheromatous plaques (CCAAP) as compared with ultrasonography. Study Design: Digital panoramic radiographs were obtained from 50 patients who also underwent carotid ultrasound examination. The images were interpreted by trained maxillofacial radiologist for the presence or absence of calcified atheromatous plaques. The extent of carotid calcification on carotid ultrasonography was determined by a trained Sonologist, which was considered as the gold standard assessment. Results: Digital panoramic radiographs had a sensitivity of 76% and specificity of 98.66% in determining CCAAP. There was a high level of agreement between diagnoses, with a kappa value of 0.8. Conclusion: To conclude, digital panoramic radiographs had good sensitivity and high specificity in detecting CCAAP. If properly trained, dentists can detect such plaques and can refer patients to physician for timely medical treatment.


Subject(s)
Calcinosis/diagnostic imaging , Calcinosis/diagnostic imaging , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/diagnostic imaging , Humans , Plaque, Atherosclerotic/diagnostic imaging , Plaque, Atherosclerotic/diagnostic imaging , Radiography, Panoramic/methods , Ultrasonography/methods
16.
West Indian med. j ; 62(7): 667-671, Sept. 2013. ilus
Article in English | LILACS | ID: biblio-1045723

ABSTRACT

Extracranial internal carotid artery aneurysms are rare. They may result in thromboembolic phenomena but spontaneous rupture is rare. The clinical presentation may be an asymptomatic neck mass or there may be symptoms of upper aerodigestive tract compression. The diagnosis may be suspected on clinical examination but radiologic investigations play an important role in diagnosis as well as in assessing the risk of complications of surgical intervention. We present a case of a patient with an extracranial internal carotid artery aneurysm, along with a short review of the treatment options.


Los aneurismas de la arteria carótida interna extracraneal son raros. Pueden ocasionar fenómenos tromboembólicos pero la ruptura espontánea no es común. La manifestación clínica puede ser una masa asintomático en el cuello, o pueden presentarse síntomas de compresión de las vías aerodigestivas superiores. Pueden producirse indicios para el diagnóstico a partir de sospechas durante el examen clínico, pero las investigaciones radiológicas desempeñan un papel importante a la hora de diagnosticar, y evaluar el riesgo de complicaciones de la intervención quirúrgica. Presentamos un caso de un paciente con un aneurisma de la arteria carótida interna extracraneal, junto con una breve reseña de las opciones de tratamiento.


Subject(s)
Humans , Middle Aged , Vascular Surgical Procedures/methods , Carotid Artery Diseases/diagnostic imaging , Carotid Artery, Internal , Aortic Aneurysm, Abdominal/diagnostic imaging , Aneurysm/diagnostic imaging , Renal Artery/diagnostic imaging , Carotid Artery Diseases/surgery , Carotid Artery, Internal/surgery , Carotid Artery, Internal/diagnostic imaging , Tomography, X-Ray Computed , Aneurysm/surgery
17.
Acta méd. (Porto Alegre) ; 34: [7], 20130.
Article in Portuguese | LILACS | ID: biblio-879925

ABSTRACT

Por meio deste artigo buscamos revisar e sintetizar a metodologia, a técnica e a aplicabilidade da ecografia de artérias carótidas. Este método de imagem que é utilizado, principalmente, para avaliar e diagnosticar a doença aterosclerótica destes vasos.


Through this article we try to review and summarize the carotid arteries ultrasound methodology, technique and applicability. This imaging method that is used mainly to appraise and diagnose these vessels atherosclerotic diseases.


Subject(s)
Carotid Artery Diseases/diagnostic imaging , Ultrasonography , Carotid Artery, Internal , Constriction, Pathologic , Ultrasonography, Doppler
18.
Journal of the Royal Medical Services. 2012; 19 (1): 5-10
in English | IMEMR | ID: emr-124888

ABSTRACT

To assess the frequency of significant carotid artery disease among the study group patients who underwent cardiac surgical procedures and highlight the importance of pre-operative Carotid Duplex Ultrasonography Scanning. This is a descriptive study which was conducted on a consecutive series of 102 Jordanian patients who underwent cardiac surgical procedures at Queen Alia Heart Institute between January and December 2009, and were pre-operatively examined for carotid artery disease. Median age of the study group patients was 63 [range 40-78] years, there were 84 males and 18 females, 76[74.5%] were hypertensive, 62[60.7%] diabetics, 67[65.6%] had history of smoking, 45[44%] had a Body Mass Index >30, 13[12.7%] had significant left main disease. Ten patients [9.8%] had a pre-operative history of transient ischemic attack or cerebrovascular accident. Chi-square was used to determine significance of the study variables, P value<0.05 was considered significant. Seventeen patients [16.6%] were found to have 50% or greater stenosis of one or both carotid arteries whereas for an 80% or greater stenosis; it was 6[5.8%]. Frequency of a 50% or greater stenosis of one or both carotid arteries was 3[6.5%] in patients between age 60 and 69 years, increasing to 11[42.3%] for patients age of 70 years and older. Independant risk factors for the presence of >50% stenosis in one or both carotid arteries in this group of patients were a previous history of transient ischemic attack or cerebrovascular accident, left main coronary disease, hypertension, history of smoking. Among 4 patients found to have concomitant significant carotid lesions and were hemodynamically stable with no critically stenotic coronary arteries, management was staged, carotid stenting was performed as a first stage in 2 patients and carotid endarterectomy was performed as a first stage in another 2 patients, cardiac procedures were performed successfully as a second stage in these 4 patients. Concomitant significant Carotid Artery Disease among the study group patients above the age of 70 who underwent cardiac procedures is relatively high, selective pre-operative Carotid Duplex Ultrasonography should be mandatory


Subject(s)
Humans , Male , Female , Preoperative Care , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/surgery , Cardiac Surgical Procedures , Prevalence , Endarterectomy, Carotid
19.
Article in English | WPRIM | ID: wpr-40418

ABSTRACT

Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiropractor eight days prior. When he first visited us, his best corrected visual acuity in his right eye was hand motion. A full ophthalmic examination was performed. There was cherry-red spot in the macula in his right eye. We performed a fluorescein angiogram and cervical color Doppler. The arterio-venous transit time in the fluorescein angiogram was delayed, and we detected stenosis of the right internal carotid artery with diffuse atherosclerotic plaques in the right common carotid artery. We prescribed ginko biloba extract (Tanamin). Three years after his first visit, the best corrected visual acuity of his right eye was 20 / 200.


Subject(s)
Carotid Artery Diseases/diagnostic imaging , Fluorescein Angiography , Humans , Male , Manipulation, Chiropractic/adverse effects , Middle Aged , Neck/blood supply , Retinal Artery Occlusion/diagnosis , Vision Disorders/diagnosis
20.
Pakistan Oral and Dental Journal. 2008; 28 (2): 249-252
in English | IMEMR | ID: emr-89648

ABSTRACT

The purpose of our study was to evaluate the incidence of CCAAs detected on panoramic radiographs of above 50-years-old patient population. Further, we evaluated the relationship between CCAAs and general and oral health examinations. Calcified carotid artery atheromas or CCAAs are projected on panoramic radiographs as a radiopaque nodular mass or masses adjacent to the cervical vertebrae at or below the intervertebral space between C3 and C4. We concluded that, panoramic radiography should be evaluated not only for pathosis of teeth and jaws, but also for other incidental findings, especially in the soft tissue region of the neck. The incidental findings could provide potentially life saving informations especially for those elderly people who are at risk for stroke


Subject(s)
Humans , Male , Female , Atherosclerosis/diagnostic imaging , Atherosclerosis/pathology , Calcinosis/diagnostic imaging , Carotid Artery Diseases/diagnostic imaging , Carotid Artery Diseases/pathology
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