Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.999
Filter
1.
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
2.
Rev. méd. Urug ; 37(3): e37312, set. 2021. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1341560

ABSTRACT

Resumen: Introducción: la vacunación contra SARS-CoV-2 es una herramienta imprescindible en el combate contra la pandemia de COVID-19. La vacuna desarrollada en colaboración entre la Universidad de Oxford y el laboratorio de productos farmacéuticos AstraZeneca (AZN) ha demostrado buena eficacia, pero ha habido reporte de trombosis venosas. Caso clínico: se presenta el caso de un paciente de 70 años, de sexo masculino, que 7 días después de la administración de la primera dosis de la vacuna AZN desarrolla trombosis venosa profunda de ambos miembros inferiores y tromboembolismo pulmonar. Coincide con trombocitopenia de 15.000/mm3, descenso del fibrinógeno y elevación de los D-dímeros. La situación clínica evoca el planteo de trombocitopenia trombótica inducida por vacuna (VITT). Se realizó tratamiento con inmunoglobulinas intravenosas, metilprednisolona y crioprecipitados. Requirió colocación de un filtro de la vena cava inferior. Una vez mejorado el recuento plaquetario se instaló tratamiento anticoagulante con apixaban. Evolucionó favorablemente. Discusión: se trata del primer reporte nacional de VITT. Las trombosis subsiguientes a la vacuna de AZN pueden verse con las vacunas que comparten la misma plataforma vacunal (adenovirus inactivado). Se han reportado casos fundamentalmente en menores de 60 años y en topografías inhabituales. Este caso tiene la particularidad de que se trata de un paciente mayor de 60 años, que ya había tenido COVID-19 cinco meses antes y que se presenta con una trombosis en sitios habituales. El manejo terapéutico se adecuó a las pautas internacionales. El caso deja un aprendizaje relevante tanto en lo que refiere al diagnóstico precoz como al manejo terapéutico.


Abstract: Introduction: vaccines against SARS-CoV-2 are an essential tool against the COVID-19 pandemic. The vaccine developed in collaboration with the University of Oxford and the AstraZeneca (AZN) laboratory has proved to be effective, although venous thrombosis have been reported. Clinical case: the study presents the case of a 70 year old male patient who, 7 days after receiving the first dose of the AZN vaccination develops deep vein thrombosis (DVT) in the lower extremities and pulmonary embolism. Simultaneously, thrombocytopenia is 15.000/mm3, fibrinogen levels drop D-dimer levels are elevated. The clinical situation leads to the suspicion of vaccine-associated immune thrombosis and thrombocytopenia (VITT). The patient was treated with intravenous immune globulin, methylprednisolone and cryoprecipitates, requiring a filter to be placed in the inferior vena cava. Once platelets count improved, anti-coagulation therapy including apixaban was commenced, evolution being good. Discussion: this is the first national report on VITT. Thrombosis after the AZN vaccination may be seen in other vaccines that use the same vaccine platform (inactive adenovirus). Cases have been reported mainly in patients younger than 60 years old and in unusual topographies. In particular, this case presents a male patient that is older than 60 years old, who had already been infected with COVID-19 five months before and who currently consults with thrombosis in regular sites. Therapeutic handling observed international guidelines. The case contributes relevant data both in terms of early diagnosis and therapeutic handling.


Resumo: Introdução: a vacinação contra a SARS-CoV-2 é uma ferramenta essencial na luta contra a pandemia de COVID-19. A vacina desenvolvida pela colaboração entre a Universidade de Oxford e o laboratório farmacêutico AstraZeneca (AZN) tem demonstrado boa eficácia, mas foram relatados casos de trombose venosa. Caso clínico: apresenta-se o caso de um paciente do sexo masculino, 70 anos, que 7 dias após a administração da primeira dose da vacina AZN desenvolveu trombose venosa profunda de ambos os membros inferiores e tromboembolismo pulmonar. Coincide com trombocitopenia de 15.000 / mm3, diminuição do fibrinogênio e aumento dos D-dímeros. A situação clínica lembra a trombocitopenia trombótica induzida por vacina (VITT). O tratamento foi realizado com imunoglobulinas intravenosas, metilprednisolona e crioprecipitados. Foi necessário colocar um filtro de veia cava inferior. Uma vez que a contagem de plaquetas melhorou, o tratamento anticoagulante com apixaban foi instalado. O paciente favoravelmente. Discussão: este é o primeiro relatório nacional de VITT. As tromboses subseqüentes à vacina AZN podem ser vistas com vacinas que compartilham a mesma plataforma (adenovírus inativado). Os casos foram relatados principalmente em pessoas com menos de 60 anos de idade e em topografias incomuns. Este caso tem a particularidade de se tratar de um paciente com mais de 60 anos, já com COVID-19 há cinco meses e que apresenta trombose em sítios comuns. O manejo terapêutico foi adaptado às diretrizes internacionais. O caso deixa um aprendizado relevante tanto no que diz respeito ao diagnóstico precoce quanto ao manejo terapêutico.


Subject(s)
Humans , Male , Aged , Pulmonary Embolism/therapy , Thrombocytopenia/therapy , Venous Thrombosis/therapy , COVID-19 Vaccines/adverse effects
3.
Article in Spanish | LILACS, CUMED | ID: biblio-1341400

ABSTRACT

Introducción: En los últimos años se ha comprobado que el riesgo de trombosis en pacientes con enfermedades oncohematológicas es elevado. Presentación del caso: Paciente masculino de 51 años de edad, con diagnóstico de leucemia promielocítica, recibió tratamiento de inducción con trióxido de arsénico y ya alcanzada la remisión morfológica de la leucemia, y sin antecedentes personales ni familiares de eventos trombóticos, presentó una trombosis venosa profunda del miembro inferior izquierdo, se trató con heparina de bajo peso molecular y warfarina. Conclusiones: El paciente evolutivamente tuvo una evolución favorable del evento trombótico y se alcanzó la remisión completa hematológica, citogenética y molecular con una adecuada calidad de vida que permitió su reinserción a su vida personal, familiar y social(AU)


Introduction: In recent years it has been proven that the risk of thrombosis in patients with oncohematological diseases has increased. Case presentation: A 51-year-old male patient, diagnosed with Promyelocytic Leukemia, received induction treatment with arsenic trioxide and the morphological remission of the leukemia had already been achieved and with no personal or family history of thrombotic events, presented a deep vein thrombosis of the left lower limb. He was treated with low molecular weight heparin and warfarin. Conclusions: The patient progressively had a favorable evolution of the thrombotic event and complete hematological, cytogenetic and molecular remission was achieved with an adequate quality of life that allowed his reinsertion into his personal, family and social life(AU)


Subject(s)
Humans , Male , Middle Aged , Leukemia, Promyelocytic, Acute/complications , Thrombophilia/prevention & control , Venous Thrombosis/complications
4.
Rev. cuba. anestesiol. reanim ; 20(2): e691, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1289356

ABSTRACT

Introducción: La trombofilia es un desorden de la hemostasia congénito o adquirido que predispone al desarrollo de trombosis. Las trombofilias congénitas más frecuentes son las deficiencias de antitrombina III, proteína C y proteína S, el factor V Leiden, la mutación del gen de la protrombina (G20210A) y las mutaciones de la enzima metilentetrahidrofolato reductasa (MTHFR). Objetivo: Describir el manejo anestésico en un paciente portador de trombofilia congénita. Presentación del caso: Se reporta un paciente de 19 años de edad con antecedentes de historia familiar y personal de trombosis venosa profunda, tratamiento con doble antiagregación plaquetaria y asociación de tres mutaciones para trombofilia congénita, G20210A, A1298C MTHFR y C677T MTHFR que recibe anestesia espinal para una herniorrafia inguinal. Se mantiene tratamiento con aspirina, se suspende clopidogrel 7 días antes de la cirugía y durante ese tiempo se administra fraxiparina 0.6 Uds. subcutánea diarias hasta 12 h antes de la cirugía, se utiliza medias elásticas, deambulación precoz y reinicio de clopidogrel 24 h después de la cirugía, con evolución satisfactoria. Conclusiones: La tromboprofilaxis en pacientes portadores de trombofilia congénita es mandatoria, por eso resulta determinante la utilización de heparina de bajo peso molecular junto al resto de las medidas de prevención de la trombosis venosa profunda(AU)


Introduction: Thrombophilia is a congenital or acquired hemostasis disorder that predisposes to thrombosis development. The commonest congenital thrombophilias are deficiencies of antithrombin III, protein C and protein S, factor V Leiden, prothrombin gene mutation (G20210A), and methylenetetrahydrofolate reductase (MTHFR) mutations. Objective: To describe the anesthetic management in a patient with congenital thrombophilia. Case presentation: The case is reported of a 19-year-old patient with a family and personal history of deep-vein thrombosis, treatment with double antiplatelet therapy and association of three mutations for congenital thrombophilia (G20210A, A1298C MTHFR and C677T MTHFR), who receives spinal anesthesia for an inguinal herniorrhaphy. Aspirin treatment is maintained. Clopidogrel is suspended seven days before surgery. During this time, fraxiparin is administered subcutaneously in 0.6-mL units daily, up to twelve hours before surgery. Elastic stockings are used, early ambulation is allowed, and clopidogrel is restarted 24 hours after surgery, with satisfactory evolution. Conclusions: Thromboprophylaxis in patients with congenital thrombophilia is mandatory, a reason why the use of low-molecular-weight heparin, together with the rest of the prevention measures against deep-vein thrombosis, is decisive(AU)


Subject(s)
Humans , Male , Young Adult , Venous Thrombosis , Anesthesia, Spinal , Antithrombin III , Early Ambulation , Stockings, Compression
5.
Oncol. (Guayaquil) ; 31(2): 122-130, 31 de agosto 2021.
Article in Spanish | LILACS | ID: biblio-1284441

ABSTRACT

Introducción: El trombo embolismo venoso (TEV), una complicación frecuente en pacientes con cáncer ginecológico. El objetivo del estudio fue determinar la incidencia de TEV profunda en pacientes diagnosticados con neoplasias útero ováricas en un centro de referencia oncológica en Guayaquil-Ecuador en el año 2019 (enero-diciembre). Metodología: El presente estudio observacional, de fuente retrospectiva se realizó en el servicio de estadística del Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" de la Sociedad de Lucha contra el Cáncer-SOLCA, Guayaquil Ecuador. El cálculo del tamaño muestral fue probabilístico de 237 pacientes. Se incluyeron casos de pacientes con neoplasias útero ováricas y endometriales. Las variables fueron edad, localización de la neoplasia, incidencia de TEV en base a evidencia Ultrasonográfica de TEV, criterios Wels, dímero D. Se utilizó estadística descriptiva. Los porcentajes se presentan con intervalo de confianza. Resultados: Se incluyeron 237 pacientes, el grupo etario más frecuente de 40 a 59 años con el 46.4%, seguido de 60 y más años con el 34.6%; el 88.6% de los casos tuvieron cáncer de útero (cérvix ­ endometrio) y el 11.4% con cáncer de ovario. Por la clasificación de Wells, el 92% presentó riesgo moderado de TVP y 8% riesgo alto. La incidencia de trombosis venosa profunda en pacientes con cáncer útero ­ ovario fue del 6.75% (IC 6.54-6.96%). La incidencia fue estadísticamente más prevalente (P=0.01) en el grupo de mujeres con Ca de Útero que en el grupo de Ca de ovario. Conclusión: Las neoplasias útero ováricas tienen alta incidencia de trombosis venosa profunda.


Introduction: Venous thrombus embolism (VTE), a frequent complication in patients with gynecological cancer. The objective of the study was to determine the incidence of deep VTE in patients diagnosed with uterine-ovarian neoplasms in an oncology referral center in Guayaquil-Ecuador in 2019. Methodology: The present observational study, from a retrospective source, was carried out in the statistics service of the National Oncological Institute "Dr. Juan Tanca Marengo" from the Society for the Fight Against Cancer-SOLCA, Guayaquil Ecuador. The calculation of the sample size was probabilistic of 237 patients. Cases of patients with uterine-ovarian and endometrial neoplasms were included. The variables were age, location of the neoplasm, incidence of VTE based on ultrasound evidence of VTE, Wels criteria, D-dimer. Descriptive statistics were used. The percentages are presented with a confidence interval. Results: 237 patients were included, the most frequent age group 40 to 59 years with 46.4%, fol-lowed by 60 and over with 34.6%; 88.6% of the cases had uterine cancer (cervix - endometrium) and 11.4% with ovarian cancer. According to the Wells classification, 92% had a moderate risk of DVT and 8% had a high risk. The incidence of deep vein thrombosis in patients with uterine-ovarian cancer was 6.75% (CI 6.54-6.96%). The incidence was statistically more prevalent (P=0.01) in the group of wom-en with Uterus Ca than in the ovarian Ca group. Conclusion: Utero-ovarian neoplasms have a high incidence of deep vein thrombosis.


Introdução: Embolia por trombo venoso (TEV), uma complicação frequente em pacientes com câncer ginecológico. O objetivo do estudo foi determinar a incidência de TEV profundo em pacientes com diagnóstico de neoplasias uterino-ovarianas em um centro de referência em oncologia em Guayaquil-Equador em 2019 (janeiro-dezembro). Metodologia: O presente estudo observacional, de fonte retrospectiva, foi realizado no serviço de estatística do Instituto Oncológico Nacional "Dr. Juan Tanca Marengo "da Sociedade de Luta contra o Câncer-SOLCA, Guayaquil, Equador. O cálculo do tamanho da amostra foi probabilístico de 237 pacientes. Foram incluídos casos de pacientes com neoplasias uterino-ovarianas e endometriais. As variáveis ​​foram idade, localização da neoplasia, incidência de TEV com base em evidências ultrassonográficas de TEV, critérios de Wels, dímero D. Foi utilizada estatística descritiva. As porcentagens são apresentadas com intervalo de confiança. Resultados: foram incluídos 237 pacientes, a faixa etária mais frequente de 40 a 59 anos com 46,4%, seguida de 60 e mais anos com 34,6%; 88,6% dos casos tiveram câncer de útero (colo do útero - endométrio) e 11,4% de câncer de ovário. De acordo com a classificação de Wells, 92% apresentaram risco moderado de TVP e 8% risco alto. A incidência de trombose venosa profunda em pacientes com câncer de útero-ovário foi de 6,75% (IC 6,54-6,96%). A incidência foi estatisticamente mais prevalente (P = 0,01) no grupo de mulheres com Ca no útero do que no grupo de Ca ovariana. Conclusão: As neoplasias útero-ovarianas apresentam alta incidência de trombose venosa profunda.


Subject(s)
Humans , Female , Adult , Middle Aged , Ovarian Neoplasms , Uterine Cervical Neoplasms , Endometrial Neoplasms , Venous Thrombosis , Embolism and Thrombosis
6.
Cambios rev. méd ; 20(1): 26-32, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292714

ABSTRACT

INTRODUCCIÓN. El tromboembolismo venoso es una complicación prevenible en pacientes hospitalizados y la estratificación del riesgo mejora la seguridad del paciente, su valoración evita su ocurrencia. OBJETIVO. Evaluar el riesgo de tromboembolismo venoso y uso adecuado de terapia tromboprofiláctica en pacientes hospitalizados. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 412 y muestra de 373 pacientes encuestados, distribuidos: 186 en Unidades Clínicas, 163 en Unidades Quirúrgicas y 24 en Obstetricia del Hospital de Especialidades Carlos Andrade Marín, desde el 21 al 23 de febrero del 2019. La tabulación y análisis de datos se realizó en el programa estadístico International Business Machines Statistical Package for the Social Sciences, versión 21. RESULTADOS. Se categorizó como alto riesgo de tromboembolismo venoso al 76,67% (286; 373) de pacientes; 49,46% (144; 163) postquirúrgicos y 69,40% (129; 286) clínicos de alto riesgo de tromboembolismo venoso, recibiendo tromboprofilaxis farmacológica de forma adecuada el 38,80% (56; 144) de quirúrgicos y 57,40% (74; 129) de clínicos. CONCLUSIÓN. Se determinó que el uso de tromboprofilaxis no farmacológica y farmacológica con heparina de bajo peso molecular en pacientes hospitalizados con riesgo de tromboembolismo venoso, fue bajo.


INTRODUCTION. Venous thromboembolism is a preventable complication in hospitalized patients and risk stratification improves patient safety, its ocurrence is prevented by its assessment. OBJECTIVE. To evaluate the risk of venous thromboembolism and ade-quate use of thromboprophylactic therapy in hospitalized patients. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 412 and sample of 373 patients surveyed, distributed: 186 in clinical wards, 163 in surgical wards and 24 in obstetrics of the Carlos Andrade Marín Specialties Hospital, from february 21 to 23, 2019. Data tabulation and analysis was performed in the statistical program International Business Machines Statistical Package for the Social Sciences, version 21. RESULTS. 76,67% (286; 373) of patients were categorized as high risk of venous thromboembolism; 49,46% (144; 163) post-surgical and 69,40% (129; 286) clinical patients as high risk of venous thromboembo-lism, with 38,80% (56; 144) of surgical and 57,40% (74; 129) of clinical patients receiving adequate pharmacological thromboprophylaxis. CONCLUSIONS. The use of nonpharma-cological and pharmacological thromboprophylaxis with low-molecular-weight heparin in hospitalized patients at risk of venous thromboembolism was low.


Subject(s)
Humans , Male , Female , Middle Aged , Thromboembolism/drug therapy , Vascular Diseases/prevention & control , Veins , Heparin/therapeutic use , Venous Thrombosis/mortality , Venous Thromboembolism/complications , Thrombolytic Therapy , Drug Therapy , Data Analysis , Hemorrhage/prevention & control , Anticoagulants
7.
Medicina (B.Aires) ; 81(3): 454-457, jun. 2021. graf
Article in Spanish | LILACS | ID: biblio-1346484

ABSTRACT

Resumen La flegmasia cerulea dolens es una complicación rara y poco frecuente de la trombosis venos a profunda. Los principales factores predisponentes son los procesos neoformativos, estados de hiper coagulabilidad, insuficiencia cardíaca congestiva, embarazo, inmovilización prolongada y cirugías. Se caracteriza por edema masivo, dolor intenso y cianosis. Sin tratamiento evoluciona con isquemia, necrosis y amputación del miembro comprometido. No existe consenso en su tratamiento, pero éste debe ser rápido, multidisciplinario y agresivo. La anticoagulación con heparina, la fibrinólisis sistémica, la trombectomía percutánea con fibrinólisis local, la trombectomía quirúrgica, la fasciotomía, la colocación de filtro de vena cava inferior y la amputación son algunos de los tratamientos propuestos.


Abstract Phlegmasia cerulea dolens (FCD) is a rare complication of deep vein thrombosis. Its cause is unknown. The main predisposing factors for the disease are neoformative processes, hypercoagulable states, congestive heart failure, pregnancy, prolonged immobilization, and surgeries on the affected limb. FCD is characterized by massive edema, severe pain, and cyanosis. The diagnosis is clinical. It is associated in most cases with pulmonary embolism and can lead to loss of the compromised limb if not treated in time. So far there is no consensus on its treatment. In clinical practice the use of anticoagulation with heparin, local thrombolysis, systemic fibrinolysis, surgical thrombectomy, fasciotomy, and inferior vena cava filter are described. In irreversible cases amputation is required. We present the case of a patient with FCD, the treatment performed and the evolution.


Subject(s)
Humans , Thrombophlebitis/drug therapy , Thrombophlebitis/diagnostic imaging , Venous Thrombosis/drug therapy , Venous Thrombosis/diagnostic imaging , Heparin , Thrombectomy , Fibrinolysis
8.
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
9.
Säo Paulo med. j ; 139(2): 190-195, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1181008

ABSTRACT

ABSTRACT BACKGROUND: Although it is known that the new coronavirus disease (COVID-19), which was first seen in Wuhan, China, in December 2019 and has affected the whole world, mainly targets the respiratory tract, cases of this disease with a wide clinical spectrum are emerging as information is shared. CASE REPORT: We present the case of a pregnant woman who was diagnosed with venous sinus thrombosis after she developed headache and hemiparesis. Polymerase chain reaction (PCR) positivity lasted for two weeks after COVID-19 had been diagnosed. CONCLUSIONS: In patients with suspected COVID-19, especially in the presence of causes of hypercoagu- lability and presence of atypical features, venous sinus thrombosis needs to be kept in mind in making the differential diagnosis.


Subject(s)
Humans , Female , Pregnancy , Venous Thrombosis/diagnosis , SARS-CoV-2/isolation & purification , SARS-CoV-2/genetics , COVID-19/complications , Headache/etiology , Paresis/etiology , Sinus Thrombosis, Intracranial/diagnostic imaging , China , Polymerase Chain Reaction , Thrombophilia , COVID-19 Testing , COVID-19/diagnosis
10.
Arch. argent. pediatr ; 119(1): 32-38, feb. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1147080

ABSTRACT

Introducción. En neonatología, más del 90 % de las trombosis venosas profundas están asociadas al uso de catéteres. El objetivo del estudio fue determinar la incidencia y los factores de riesgo relacionados con trombosis venosa profunda asociada a catéteres venosos centrales.Población y métodos. Estudio observacional analítico de cohorte prospectivo. Se incluyeron todos los catéteres venosos centrales mediante un muestreo no aleatorio consecutivo. El protocolo de pesquisa incluyó la evaluación clínica diaria y ecografía doppler (7-10 días luego de su colocación y/o a las 72 h de su retiro). Seguimiento: desde la colocación al retiro del catéter, fallecimiento o contrarreferencia del paciente. Se estimó densidad de incidencia cada 1000 días/catéter con sus intervalos de confianza (IC) del 95 % y factores de riesgo mediante análisis multivariado de Cox.Resultados. Se identificó trombosis en 22/264 catéteres. La densidad de incidencia de trombosis fue del 5,33 ‰ días/catéter (IC 95 %: 3,34-8,07). La cirugía cardiovascular y el uso de catéteres distintos a los epicutáneos resultaron ser factores de riesgo independientes para trombosis [Hazard Ratio: (3,8 [IC 95 %: 1,6-9] y 2,75 [IC 95 %: 1,17-6,45]).Conclusiones. La incidencia de trombosis venosa profunda asociada a catéteres venosos centrales fue de 5,33 cada 1000 días/catéter. El antecedente de procedimientos quirúrgicos cardiovasculares y el uso de catéteres distintos a los epicutáneos se asociaron con mayor riesgo de la complicación.


Introduction. In neonatology, more than 90 % of deep vein thromboses are related to catheter use. The objective of this study was to determine the incidence and risk factors associated with central venous catheter-related deep vein thrombosis.Population and methods. Observational and analytical study conducted in a prospective cohort. All central venous catheters were included using consecutive, non-random sampling. The screening protocol included a daily clinical examination and a Doppler ultrasound (7-10 days after insertion and/or 72 h after removal). Follow-up: from catheter insertion to catheter removal, death or patient counter-referral. The incidence density rate per 1000 catheter-days was estimated with its corresponding 95 % confidence intervals (CIs), and risk factors, using Cox multivariate analysis.Results. Thrombosis was identified in 22/264 catheters. The incidence density rate of thrombosis was 5.33 ‰ catheter-days (95 % CI: 3.34-8.07). Cardiovascular surgery and and the use of central catheters others than peripherally inserted ones, were independent risk factors for thrombosis (hazard ratio: 3.8 [95 % CI: 1.6-9] and 2.75 [95 % CI: 1.17-6.45]).Conclusions. The incidence of central venous catheter-related deep vein thrombosis was 5.33 per 1000 catheter-days. A history of cardiovascular surgical procedures and and the use of central catheters others than peripherally inserted ones, were associated with a higher risk of this complication.


Subject(s)
Humans , Male , Female , Infant, Newborn , Venous Thrombosis , Central Venous Catheters/adverse effects , Incidence , Prospective Studies , Risk Factors , Neonatology
11.
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
12.
Bol. méd. postgrado ; 37(1): 21-26, Ene-Jun 2021. graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1147874

ABSTRACT

El tratamiento anticoagulante oral con fármacos inhibidores de la vitamina K como la warfarina se viene utilizando desde hace décadas para la terapia y prevención de la enfermedad tromboembólica con efectos secundarios ampliamente conocidos, pero con una utilidad clínica bien contrastada. El objetivo de este estudio fue determinar la proporción de mortalidad y hospitalización de la consulta de anticoagulación y trombosis del Centro Cardiovascular Regional ASCARDIO en el año 2017 para lo cual se realizó un estudio descriptivo transversal que incluyó una muestra de 294 pacientes. La principal indicación de anticoagulación fue la fibrilación auricular (73%) seguida de la enfermedad tromboembólica venosa (13%) e isquemia miocárdica (9%). Se registró una mortalidad de 11,7% siendo la principal causa de muerte de origen cardíaco (58%). La edad promedio de los pacientes fallecidos fue de 65 años, siendo 53% del sexo femenino; para el momento de la muerte, el 65% de los pacientes estaba tomando warfarina. La hospitalización se observó en el 10% de la muestra siendo la principal causa de la misma la cardíaca (60%) seguida de causas hemorrágicas (18%); de los pacientes hospitalizados, la edad promedio fue de 66 años siendo 52% del sexo femenino; el 90% de los pacientes estaba tomando warfarina al momento de la hospitalización. El análisis de riesgo para mortalidad y hospitalización según causa y estatus de warfarina no mostró significancia estadística. No se evidenció relación de riesgo estadísticamente significativa entre muerte, hospitalización y estatus de la warfarina. Hubo mayor proporción de muertes (45%) y hospitalización (17%) en el grupo que ingresó con diagnóstico de isquemia miocárdica(AU)


Oral anticoagulant treatment with vitamin K inhibitor drugs such as warfarin has been used for decades for the therapy and prevention of thromboembolic disease with widely known side effects but with well-proven clinical utility. To determine the proportion of mortality and hospitalization of the anticoagulation and thrombosis clinic of the ASCARDIO Regional Cardiovascular Center in 2017 a descriptive cross-sectional study was carried out that included a sample of 294 patients. The results show that the main indication for anticoagulation was atrial fibrillation (73%) followed by venous thromboembolic disease (13%) and myocardial ischemia (9%). An 11.7% mortality rate was observed. The mean age of the deceased was 65 years with a slight prevalence of the female sex (53%). The main cause of death was cardiac (58%) and 65% of the deceased patients were taking warfarin at the moment of death. A 10% hospitalization rate was observed with an average age of hospitalized patients of 66 years; 52% were females. The main cause of hospitalization was cardiac (60%) followed by hemorrhage (18%) and 90% of the patients were taking warfarin at the time of hospitalization. The risk analysis for mortality and hospitalization according to cause and status of warfarin did not show statistical significance. There was a higher proportion of deaths (45%) and hospitalization (17%) in the group admitted with a diagnosis of myocardial ischemia(AU)


Subject(s)
Humans , Male , Female , Aged , Vitamin K/antagonists & inhibitors , Warfarin/therapeutic use , Venous Thrombosis/drug therapy , Anticoagulants , Atrial Fibrillation/drug therapy , Thromboembolism , Vascular Diseases , Myocardial Ischemia/drug therapy
13.
São Paulo; s.n; HSPM; 2021.
Thesis in Portuguese | LILACS, ColecionaSUS, SMS-SP, HSPM-Producao, SMS-SP | ID: biblio-1348507

ABSTRACT

RESUMO Durante décadas a única opção para o tratamento medicamentoso das condições tromboembólicas venosas foi o uso das heparinas seguido dos antagonistas da vitamina K, como a varfarina sódica, que se demonstravam efetivos no tratamento de tais condições, porém essa medicação possui algumas desvantagens como: janela terapêutica estreita, interações com outras medicações e alimentos, além do fato de requerer monitorização laboratorial periódica. Com o surgimento dos novos anticoagulantes orais, tais drogas apareceram como uma alternativa ao tratamento da TVP, demonstrando através de diversos estudos sua não inferioridade em relação a eficácia da anticoagulação, bem como uma série de vantagens quando comparados ao tratamento convencional. Nesse sentido, este projeto se propõe a avaliar a prática clínica da cirurgia vascular do HSPM no tratamento medicamentoso da TVP e demonstrar com o que já se tem descrito na literatura sobre a atual participação e benefícios dos novos anticoagulantes orais no manejo da TVP. Para isso foram utilizados os prontuários eletrônicos do HSPM acerca de pacientes internados pela Cirurgia Vascular com TVP no intervalo entre junho de 2020 a junho de 2021 para o levantamento da medicação administrada. Também foram utilizados dados da literatura de referência para respaldar a comparação entre os anticoagulantes convencionais e os novos anticoagulantes. Os resultados obtidos apontam para a baixa utilização dos novos anticoagulantes orais no HSPM, sendo oferecido a apenas 5 dos 55 pacientes internados no intervalo de um ano, isso porque o SUS não fornece a medicação, tendo como justificativa o impacto orçamentário sem ganho significativo de eficácia. A literatura consultada, no entanto, relata a segurança e eficácia satisfatória dos novos anticoagulantes orais, e indica que apesar desses medicamentos serem mais caros que a varfarina, há considerável redução dos custos relativos à internação e/ou acompanhamento médico. Assim, conclui-se que essas novas drogas são boas alternativas ao tratamento convencional, porém deve haver adequação ao quadro do paciente, às suas condições socioeconômicas e à disponibilidade do SUS. Palavras-chave: Novos anticoagulantes orais. Trombose. Varfarina. Trombose venosa profunda. Xarelto


Subject(s)
Humans , Male , Female , Thrombosis , Vitamin K , Venous Thrombosis , Anticoagulants
14.
Article in Chinese | WPRIM | ID: wpr-880164

ABSTRACT

OBJECTIVE@#To investigate the causes, treatment options and outcomes of immune thrombocytopenia (ITP) patients with splanchnic venous thrombosis (SVT).@*METHODS@#The clinical diagnosis, treatment and outcomes data of one 26-year-old male ITP patient with SVT as initial manifestation were collected. The possible causes and treatment options of the patients were discussed through literatures review.@*RESULTS@#The result of blood routine tests of the patient showed that Plt(17-38)×10@*CONCLUSION@#ITP combined with large scale of SVT is rare, and it is difficult to cure. It should be pay more attention to the possible thrombosis risk triggered by a transiently increased EOS in the blood stream. Promptly etiological treatment and the balance between anticoagulant therapy and bleeding risks should be taken in clinical practice.


Subject(s)
Aged, 80 and over , Anticoagulants/therapeutic use , Heparin, Low-Molecular-Weight , Humans , Male , Purpura, Thrombocytopenic, Idiopathic/complications , Splanchnic Circulation , Venous Thrombosis
15.
Article in Chinese | WPRIM | ID: wpr-880118

ABSTRACT

OBJECTIVE@#To test the anticoagulation functions, perform the genetic diagnosis and analyze the clinical characteristics in a family with combined heterozygous genetic variants of PROC and PROS1.@*METHODS@#Peripheral blood was collected from all the family members. Hematological phenotypes and activity of anticoagulant factors were analyzed. Target genes were amplified by PCR from DNA isolated from peripheral blood, and then were analyzed by Sanger DNA sequencing.@*RESULTS@#Many members in the family displayed the combined genetic variants in protein C and protein S, and six family members accompanied by deep venous thrombosis (DVT). The influences of genetic and secondary factors on the incidence of venous thrombosis in the family members were analyzed. The results showed that in this family, carriers of combined protein C and protein S gene defects had a higher incidence of VTE, but acquired factors still played a key role in the eventual thrombotic symptoms.@*CONCLUSION@#Venous thromboembolism (VTE) is a multifactorial disease, the combined genetic heterozygous mutations of protein C and S is an important genetic factor, and the clinical phenotype show a high heterogenicity, the secondary factors contribute to the VTE incidence.


Subject(s)
Heterozygote , Humans , Mutation , Protein C/genetics , Protein S/genetics , Risk Factors , Venous Thromboembolism , Venous Thrombosis/genetics
16.
Autops. Case Rep ; 11: e2020188, 2021. graf
Article in English | LILACS | ID: biblio-1142403

ABSTRACT

Venous aneurysm of the head and neck is a rare clinical entity due to its asymptomatic nature and tendency of clinicians to report only surgical results. Whereas the primary aneurysm of internal jugular vein (IJV) in children is being increasingly recognized, secondary aneurysms of veins of the head and neck in adults, notably the external jugular vein (EJV) aneurysm remains only in anecdotal case reports. We present the case of a 63-year-old previously healthy woman who presented with a gradually progressive right lateral neck swelling over the last 18 months. Following the evaluation, she was diagnosed as a case of isolated spontaneous right-sided EJV aneurysm and was managed by surgical excision of the aneurysm.


Subject(s)
Humans , Female , Middle Aged , Venous Thrombosis/pathology , Jugular Veins/pathology , Aneurysm/pathology
17.
Clinics ; 76: e2184, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153968

ABSTRACT

Non-tumoral portal vein thrombosis (PVT) is associated with higher morbidity and mortality in liver transplantation (LT). In this study, we aimed to evaluate the impact of PVT in LT outcomes and analyze the types of surgical techniques used for dealing with PVT during LT. A systematic review was conducted in Cochrane, MEDLINE, and EMBASE databases, selecting articles from January 1990 to December 2019. The MESH-terms used were ("Portal Vein"[Mesh] AND "Thrombosis"[Mesh] NOT "Neoplasms"[Mesh]) AND ("Liver Transplantation"[Mesh]). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) recommendation was used, and meta-analysis was performed with Review Manager Version 5.3 software. A total of 1,638 articles were initially found: 488 in PubMed, 289 in Cochrane Library, and 861 in EMBASE, from which 27 were eventually selected for the meta-analysis. Surgery time of LT in patients with PVT was longer than in patients without LT (p<0.0001). Intraoperative red blood cell (p<0.00001), fresh frozen plasma (p=0.01), and platelets (p=0.03) transfusions during LT were higher in patients with PVT. One-year (odds ratio [OR] 1.17; p=0.002) and 5-year (OR 1.12; p=0.01) patient survival after LT was worse in the PVT group. Total occlusive PVT presented higher mortality (OR 3.70; p=0.00009) and rethrombosis rates (OR 3.47 [1.18-10.21]; p=0.02). PVT Yerdel III/IV classification exhibited worse 1-year [2.04 (1.21-3.42); p=0.007] and 5-year [0.98 (0.59-1.62); p=0.93] patient survival. Thrombectomy with primary anastomosis was associated with better outcomes. LT in patients with non-tumoral PVT demands more surgical time, needs more intraoperative transfusion, and presents worse 1- and 5-year patient survival. Total occlusive PVT and Yerdel III/IV PVT classification were associated with higher mortality. (PROSPERO, registration number: CRD42020132915).


Subject(s)
Humans , Liver Transplantation , Venous Thrombosis , Portal Vein/surgery , Retrospective Studies , Treatment Outcome , Thrombectomy , Liver Cirrhosis
18.
MedUNAB ; 24(2): 276-278, 20210820.
Article in Spanish | LILACS | ID: biblio-1291941

ABSTRACT

Señor editor. Desde que empezó la pandemia causada por el coronavirus COVID-19, hemos estado en un constante aprendizaje. Los países se han visto obligados a responder con sus mejores estrategias, para intentar que los sistemas de salud no colapsen y resguardar la vida de las poblaciones. Con este propósito, se han establecido medidas de contención y servicios de hospitalización organizados, además del papel fundamental de las unidades de cuidados intensivos para tratar las infecciones de gravedad, con lo cual se han evitado miles de muertes. A fecha de 11 de junio de 2021, en Colombia se habían reportado 3,724,705 casos, de los cuales 3,457,117 corresponden a los recuperados, lo cual es asimilable a quienes no perdieron la vida. Sin embargo, desconocemos cuántos de ellos tendrán consecuencias físicas y emocionales derivadas de la infección por COVID-19 (1).


Mr. editor, Since the COVID-19 coronavirus pandemic began, we have been in constant learning. Countries have been forced to respond with their best strategies, to try to prevent health systems from collapsing and to protect the lives of populations. To this end, containment measures and organized hospitalization services have been established, in addition to the fundamental role of intensive care units in treating serious infections, thus preventing thousands of deaths. As of June 11, 2021, 3,724,705 cases had been reported in Colombia, of which 3,457,117 correspond to those recovered, which is comparable to those who did not lose their lives. However, we do not know how many of them will have physical and emotional consequences derived from COVID-19 infection (1).


Sr. editor. Desde o início da pandemia de coronavírus COVID-19, estamos em constante aprendizado. Os países foram forçados a responder com suas melhores estratégias, para tentar evitar o colapso dos sistemas de saúde e para proteger a vida das populações. Para tanto, foram instituídas medidas de contenção e organização dos serviços de internação, além do papel fundamental das unidades de terapia intensiva no tratamento de infecções graves, evitando milhares de mortes. Até 11 de junho de 2021, 3.724.705 casos foram notificados na Colômbia, dos quais 3.457.117 correspondem aos recuperados, o que é comparável aos que não perderam a vida. No entanto, não sabemos quantos deles terão consequências físicas e emocionais decorrentes da infecção por COVID-19 (1).


Subject(s)
Coronavirus Infections , Pulmonary Fibrosis , Rehabilitation , Venous Thrombosis
19.
Rev. med. Risaralda ; 26(2): 157-159, jul.-dic. 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1150024

ABSTRACT

Resumen La hipertensión portal se define como la alteración patológica en el gradiente de presión a nivel del sistema portal, es decir, la diferencia entre la presión de la vena porta y la vena cava inferior. El valor normal es entre 1-5 mm Hg y se considera hipertensión cuando es mayor de 10 mm Hg. En este artículo, se describe el caso de una paciente de 5 años con un cuadro de hipertensión portal secundario a várices esofágicas y trombosis de la vena porta, confirmado por endoscopia de vías digestivas alta y angioresonancia magnética. La paciente fue atendida en la Fundación Clínica Infantil Club Noel de la ciudad de Cali, Colombia, entre los meses de diciembre del 2018 y febrero del 2019.


Abstract Portal hypertension is defined as the pathological increase in the portal pressure gradient, which is the difference between the pressure of the portal vein and the inferior vena cava. Normally portal vein pressure ranges between 1-5 mmHg and is considered hypertension when it is higher than 10 mmHg. In this study the case of a 5-year-old patient that suffers from secondary portal hypertension to portal venous thrombosis and esophageal varices is presented. The diagnostic is confirmed by an endoscopy of the upper gastrointestinal tract and by a magnetic angioresonance. The patient was treated at the Fundacion Clinica Infantil Club Noel located in Cali, Colombia, between the months of December 2018 and February 2019.


Subject(s)
Humans , Female , Child, Preschool , Portal Vein , Esophageal and Gastric Varices , Venous Thrombosis , Hypertension , Hypertension, Portal , Pressure , Vena Cava, Inferior , Portal Pressure , Gradient , Upper Gastrointestinal Tract , Endoscopy
20.
Rev. méd. Maule ; 36(2): 68-73, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1344690

ABSTRACT

Popliteal artery aneurysms is the most frequent peripheral aneurysm, predominantly affects men over 60 years of age and has a high morbidity associated to his complications, among which are ischemic complication, which can often end in amputation of the limb. Less frequent complications such as neuropathic and venous complications, particularly deep vein thrombosis, are equally relevant. Case presentation: Patient with an aneurysm of the popliteal artery complicated by thrombosis of the adjacent popliteal vein. Color Doppler ultrasound plays a fundamental role in the diagnosis.


Subject(s)
Humans , Popliteal Artery/surgery , Popliteal Artery/diagnostic imaging , Venous Thrombosis/etiology , Ultrasonics , Bone Neoplasms/complications , Echocardiography, Doppler , Osteochondroma/complications , Aneurysm
SELECTION OF CITATIONS
SEARCH DETAIL