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1.
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
2.
Hematol., Transfus. Cell Ther. (Impr.) ; 42(1): 62-69, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090466

ABSTRACT

Abstract Due to the longer survival of critically ill children, venous thromboembolism is a problem which is becoming increasingly recognized in pediatric practice. In the last decades, several international studies have been published, shedding a light upon the epidemiology of this disease during childhood. These data show peculiarities in the clinical presentation and the significant morbidity and mortality. The new "epidemic of thrombosis" in pediatric hospitals points toward the urgent need for specific treatment and prevention protocols targeting this population. In Brazil, knowledge regarding this disease remains scarce. The lack of epidemiological data impacts both the clinical care and the design of specific public policies in the field. Thus, a national registry of pediatric venous thromboembolism is relevant to the proposal of an appropriate plan of action to create a qualified net of assistance. The improvement in educational initiatives related to the field of Pediatric Hemostasis is also very important. In this review, we have updated the epidemiological, clinical and therapeutic aspects of the disease, as well as the prevention strategies.


Subject(s)
Humans , Male , Female , Child , Child , Epidemiology , Risk Factors , Venous Thrombosis/diagnosis , Venous Thrombosis/epidemiology
4.
Afr. j. neurol. sci. (Online) ; 38(1): 11-18, 2019. ilus
Article in French | AIM, AIM | ID: biblio-1257444

ABSTRACT

Introduction:La thrombose veineuse cérébrale représente une pathologie vasculaire veineuse autrefois dite rare. Objectif:L'objectif principal de notre étude était d'étudier les différents aspects cliniques, paracliniques, étiologiques et évolutifs des thromboses veineuses cérébrales. Méthodologie:Il s'agissait d'une étude prospective de 30 cas de thromboses veineuses cérébrales admis au service deneurologie de Fann durant la période allant de janvier 2013 à juillet 2016. L'imagerie cérébrale était le critèreindispensable pour confirmer le diagnostic.Résultats:Notre enquête comportait 21 femmes et 9 hommes avec un âge moyen de 34,4 ans. L'installation des signes était subaigüe dans la majorité des cas. Le motif d'admission était polymorphe, dominé par les céphalées(86,7%), les vomissements (60,0%), l'hémiplégie (56,7%). L'imagerie cérébrale révélait majoritairement 14 cas de thrombose du sinus latéral (46,7 %) et 10 cas de sinus longitudinal supérieur (33,3%). Les causes non infectieuses (50%) notamment gynéco-obstétricales dominaient. L'évolution sous héparinothérapie était le plus souvent favorable ; seules des céphalées séquellaires demeuraient. Conclusion La thrombophlébite cérébrale constitue une urgence pronostique et thérapeutique. La variabilité du diagnostic pourrait expliquer le retard de la prise en charge


Subject(s)
Academic Medical Centers , Disease Progression , Senegal , Venous Thrombosis/diagnosis , Venous Thrombosis/etiology
5.
J. vasc. bras ; 18: e20180107, 2019. tab
Article in Portuguese | LILACS | ID: biblio-1012631

ABSTRACT

O tromboembolismo venoso (TEV), que compreende o espectro de manifestações de trombose venosa profunda e/ou embolia pulmonar, é uma complicação comum, grave e evitável em pacientes hospitalizados. Embora a perda da mobilidade recente ou continuada represente um dos principais fatores de risco relacionados ao desenvolvimento de TEV, não existem critérios claros e uniformes para a definição do conceito de imobilidade. A diversidade dessas descrições dificulta a interpretação e a comparação dos resultados de estudos clínicos randomizados no que se refere à influência dos diferentes níveis de imobilidade na magnitude do risco de TEV e ao papel da deambulação precoce, de forma isolada, na prevenção de tais eventos. O entendimento dessas limitações é mandatório para a utilização e interpretação adequadas das ferramentas de avaliação de risco de TEV, e para a indicação da melhor estratégia de prevenção de trombose em pacientes clínicos hospitalizados. O objetivo deste estudo é revisar as principais evidências da literatura quanto ao papel da deambulação na prevenção do TEV


Venous thromboembolism (VTE) encompasses the spectrum of manifestations of deep venous thrombosis and/or pulmonary embolism and is a common, serious, and preventable complication in hospitalized patients. Although immobility plays an important role in determining VTE risk in medical patients, no clear and uniform criteria exist to guide clinicians in assessing immobility. The variation in the descriptions that do exist makes it difficult to interpret and compare the results of randomized clinical trials with respect to the influence of different levels of immobility on the magnitude of VTE risk and the role that early ambulation as an isolated factor plays in prevention of such events. Understanding these limitations is a prerequisite for the proper use and interpretation of VTE risk assessment tools and for indicating the best strategy for preventing venous thrombosis in hospitalized medical patients. The objective of this study was to review the main evidence reported in the literature on the role of ambulation in prevention of VTE


Subject(s)
Humans , Male , Female , Adult , Patients , Walking , Venous Thromboembolism/prevention & control , Pulmonary Embolism/therapy , Thrombolytic Therapy/methods , Acute Disease/therapy , Risk Factors , Venous Thrombosis/complications , Venous Thrombosis/diagnosis , Mobility Limitation , Patient Safety
6.
Rev. chil. pediatr ; 89(5): 621-629, oct. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978134

ABSTRACT

Resumen: Introducción: La trombosis venosa intracraneal (TVI) es una condición infrecuente y poco estudiada en población pediátrica. Objetivos: Describir y comparar características clínicas/radiológicas de ni ños no neonatos con TVI según edad y analizar la asociación de estas variables con deterioro funcio nal al alta o mortalidad aguda. Metodología: Estudio observacional de una cohorte de niños > 30 días con una primera TVI diagnosticada con imágenes/venografía por resonancia magnética encefálica. Medimos funcionalidad con la escala modificada de Rankin definiendo compromiso funcional mar cado con 3 a 5 puntos. Comparamos los promedios de edades entre grupos con y sin las diferentes variables estudiadas con la prueba U-Mann-Whitney (significancia < 0,05). Realizamos análisis de regresión logística para estimar el riesgo de resultado adverso de cada variable expresado en Odds Ra tios (ORs) e intervalos de confianza (IC) al 95%. Resultados: De 21 pacientes, 42.8% eran niñas, me diana de edad 6,27 años (rango intercuartil: 0,74-10). El promedio de edad fue menor en niños con retardo diagnóstico > 48 h (p = 0,041), puntaje < 12 en la escala coma de Glasgow (p = 0,013), crisis epilépticas (p = 0,041), trombosis de seno recto (p = 0,011) y hemorragia intracraneal (p = 0,049); mientras que fue mayor en niños con síndrome de hipertensión endocraneal (p = 0,008). La presen cia de alguna condición crónica sistémica (OR = 11,2; IC = 1,04-120,4), TVI profunda (OR = 14; IC = 1,3-150,8) e infarto encefálico (OR = 15,8; IC = 1,4-174,2) se asoció a compromiso funcional marcado o mortalidad al alta. Conclusiones: Las características clínicas/radiológicas de la TVI varían según la edad. Las patologías crónicas, compromiso del sistema venoso profundo e infarto encefálico predicen mal pronóstico a corto plazo.


Abstract: Introduction: Cerebral venous thrombosis (CVT) is an uncommon and poorly studied condition in the pediatric population. Objectives: To describe and compare the clinical and radiological features of non-neonatal children with CVT according to age and to analyze their association with functional impairment or mortality at hospital discharge. Methodology: An observational cohort study of chil dren older than 30 days with a first CVT diagnosed with imaging/venography by magnetic resonance (IMR/VMR). We measure functionality with the modified Rankin scale defining marked impairment with 3 to 5 points. We used U-Mann-Whitney test to compare ages averages between groups with and without the different studied variables (significance < 0.05). We used logistic regression analyses to estimate the risk of adverse outcome for each variable expressed in Odds Ratios (ORs) and 95% confidence intervals (CI). Results: Among 21 patients recruited, 42.8% were girls, median age 6.27 years (Interquartile range: 0.74-10). The average age was lower in children with diagnostic delay > 48 hours (p = 0.041), score < 12 in the Glasgow coma scale (p = 0.013), seizures (p = 0.041), sinus rectus thrombosis (p = 0.011), and intracranial hemorrhage (p = 0.049); while it was significantly higher in children with intracranial hypertension syndrome (p = 0.008). The presence of some chro nic systemic condition (OR = 11.2; CI = 1.04-120.4), deep CVT (OR = 14; CI = 1.3-150.8), and brain ischemia (OR = 15.8; CI = 1.4-174.2) was associated with marked functional impairment or mor tality at discharge. Conclusions: Clinical and radiological features of CVT are age-related. Chronic illnesses, deep venous system involvement, and brain ischemia predict adverse short-term outcomes.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Cerebral Veins/diagnostic imaging , Magnetic Resonance Imaging , Venous Thrombosis/diagnosis , Neuroimaging , Prognosis , Logistic Models , Cohort Studies , Age Factors , Venous Thrombosis/complications , Venous Thrombosis/mortality
7.
Article in French | AIM, AIM | ID: biblio-1263846

ABSTRACT

La tuberculose est un facteur de risque de maladies thromboemboliques. Nous rapportons le cas d'une fille de dix ans qui a présenté un premier épisode de thrombose veineuse profonde découverte devant une douleur du membre pelvien droit avec œdème et impotence fonctionnelle, confirmée par un échodoppler des vaisseaux de la cuisse. Lors de la recherche de la cause, la tuberculose pulmonaire a été diagnostiquée selon les critères de l'Union Internationale Contre la Tuberculose et les Maladies Respiratoires. La patiente a été mise sous des antituberculeux associés à l'héparine de bas poids moléculaire relayée par l'anti vitamine K. L'évolution a été favorable. Il conviendrait en l'absence de diagnostic microbiologique de la tuberculose dans les pays à ressources limitées, d'évoquer une tuberculose devant toute thrombose veineuse profonde associée à une pneumonie


Subject(s)
Antitubercular Agents , Central African Republic , Pediatrics , Tuberculosis/therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/etiology
8.
Rev. chil. obstet. ginecol. (En línea) ; 82(5): 534-538, Nov. 2017. tab, graf
Article in English | LILACS | ID: biblio-899939

ABSTRACT

Se presentan 3 casos de trombosis de la vena ovárica, uno en relación a cirugía pélvica y dos durante el postparto. La trombosis de la vena ovárica es una complicación rara, de presentación clínica inespecífica, lo que hace plantearse un diagnóstico diferencial con otras patologías más frecuentes (apendicitis, pielonefritis, etc), siendo la TAC el gold standard para su diagnóstico. El tratamiento más adecuado son los anticoagulantes.


We report 3 cases of varian vein thrombosis, one in relation with pelvic surgery and 2 during the postpartum period. The ovarian vein thrombosis is a rare complication, with inespecific symptoms, that is why it is obligatory to propose a differential diagnosis with more frecuent patologies (appendicitis, pyelonephritis, etc.), the CAT is the gold standard in its diagnosis. Anticoagulants are the most suitable treatment.


Subject(s)
Humans , Male , Adult , Middle Aged , Ovarian Diseases/complications , Ovary/blood supply , Venous Thrombosis/etiology , Venous Thrombosis/drug therapy , Gynecologic Surgical Procedures/adverse effects , Venous Thrombosis/diagnosis , Postpartum Period , Anticoagulants/therapeutic use
9.
J. vasc. bras ; 16(3): f:199-l:204, jul.-set. 2017. tab
Article in Portuguese | LILACS | ID: biblio-876806

ABSTRACT

Contexto: Embora preconizada, a profilaxia de tromboembolismo venoso (TEV) deixa de ser realizada sistematicamente em pacientes internados. Objetivo: Verificar se os pacientes hospitalizados recebem a prescrição correta da profilaxia de TEV do médico responsável por sua internação, conforme sua categoria de risco. Métodos: Estudo transversal com análise de prontuários de pacientes internados no Hospital Santa Casa de Misericórdia de Curitiba, PR, entre 20 de março e 25 de maio de 2015. Excluíram-se os pacientes em uso de anticoagulantes ou com sangramento ativo. Analisou-se gênero, idade, tipo de cobertura de saúde, especialidade responsável pelo paciente e fatores de risco dos pacientes para classificá-los em alto, moderado ou baixo risco para TEV. Comparou-se o uso ou não da profilaxia entre as prescrições das especialidades clínicas e cirúrgicas, pacientes internados pelo Sistema Único de Saúde (SUS) e por convênios e de acordo com seu risco para TEV. Resultados: Dos 78 pacientes avaliados, oito preencheram os critérios de exclusão. Dos 70 pacientes elegíveis (média etária 56,9 anos; 41 homens; 62 cobertos pelo SUS), 31 eram tratados por clínicos e 39 por cirurgiões. Apenas 46 (65,71%) pacientes receberam profilaxia para TEV. Dentre os pacientes clínicos, 29 (93,5%) receberam profilaxia, contra 17 (43,6%) do grupo cirúrgico (p < 0,001). Pacientes clínicos de moderado e alto risco receberam mais profilaxia que os cirúrgicos (p < 0,001 e p = 0,002). Não houve diferenças quanto à cobertura de saúde (SUS versus convênios médicos). Conclusões: No Hospital Santa Casa de Misericórdia de Curitiba, pacientes cirúrgicos estão menos protegidos de eventos tromboembólicos em relação aos clínicos


Background: Although prophylaxis to prevent venous thromboembolism is recommended, it is rarely systematically performed in hospitalized patients. Objective: To investigate whether hospitalized patients are given the correct VTE prophylaxis prescription by the physician responsible for them while in hospital, analyzed by risk category. Methods: This was a cross-sectional study based on analysis of medical records for patients admitted to the Hospital Santa Casa de Misericórdia, Curitiba, PR, Brazil, from March 20 to May 25, 2015. Patients on anticoagulants or with active bleeding were excluded. The following variables were analyzed: sex, age, type of healthcare coverage, specialty responsible for the patient, and patients' risk factors to classify them as at high, moderate, or low risk of VTE. Use or not of prophylaxis was compared across prescriptions made by clinical and surgical specialties, between patients treated on the Brazilian National Health Service (SUS - Sistema Único de Saúde) and private health insurance, and according to patients' risk of VTE. Results: Eight of the 78 patients assessed met exclusion criteria. The remaining 70 eligible patients had a mean age of 56.9 years, 41 were male, 62 were treated on the SUS, 31 were treated by clinicians, and 39 were treated by surgeons. Just 46 (65.71%) patients were given prophylaxis for VTE. Among the clinical patients, 29 (93.5%) were given prophylaxis, against 17 (43.6%) in the surgical group (p < 0.001). Moderate and high risk clinical patients were more likely to be given prophylaxis than surgical patients (p < 0.001 and p = 0.002). There were no differences with relation to type of healthcare coverage (SUS vs. private healthcare). Conclusions: At the Hospital Santa Casa de Misericórdia in Curitiba, surgical patients are less well protected from thromboembolic events than clinical patients


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Disease Prevention , Patients , Venous Thromboembolism/complications , Age Factors , Cross-Sectional Studies , Drug Therapy/methods , Heparin/administration & dosage , Hospitalization , Risk Factors , Venous Thrombosis/complications , Venous Thrombosis/diagnosis
10.
J. vasc. bras ; 16(2): f:104-l:112, abr.-jun. 2017. ilus, tab, graf
Article in Portuguese | LILACS | ID: biblio-859594

ABSTRACT

Contexto: Os cateteres venosos centrais de inserção periférica (PICC) são dispositivos intravenosos, introduzidos através de uma veia superficial ou profunda da extremidade superior ou inferior até o terço distal da veia cava superior ou proximal da veia cava inferior. Apresentam maior segurança para infusão de soluções vesicantes/irritantes e hiperosmolares, antibioticoterapia, nutrição parenteral prolongada (NPT) e uso de quimioterápicos; demonstram reduzido risco de infecção em comparação a outros cateteres vasculares e maior relação custo/benefício se comparados ao cateter venoso de inserção central (CVCIC). Objetivos: Apresentar os resultados de implantes de PICCs ecoguiados e posicionados por fluoroscopia realizados no Hospital e Maternidade São Luiz (HMSL) Itaim, Rede D'or, Brasil. Métodos: Estudo prospectivo, não randomizado, realizado entre fevereiro de 2015 e novembro de 2016. Utilizou-se protocolo pré-estabelecido pela instituição em casos de solicitação de acesso vascular. Foram analisadas indicações, doenças prevalentes, tipo do cateter implantado, sucesso técnico, complicações relacionadas ao cateter, e estabelecidos critérios de inclusão e exclusão. Resultados: Solicitados 256 acessos vasculares, sendo implantados 236 PICCs (92,1%) e 20 CVCICs (7,9%). Principais indicações: antibioticoterapia prolongada (52,0%), NPT (19,3%) e acesso venoso difícil (16,0%). Houve sucesso técnico em 246 cateteres implantados (96,1%). A veia basílica direita foi a principal veia puncionada em 192 pacientes (75,0%), seguida da braquial direita em 28 pacientes (10,9%). Conclusões: O implante dos PICCs ecoguiados e posicionados por fluoroscopia demonstrou baixa incidência de complicações, reduzidos índices de infecção e é seguro e eficaz em casos de acessos vasculares difíceis, sendo esses cateteres considerados dispositivos de escolha em acesso vascular central


Background: Peripherally inserted central catheters (PICC) are intravenous devices inserted through a superficial or deep vein of an upper or lower extremity and advanced to the distal third of the superior vena cava or proximal third of the inferior vena cava. They offer the advantages of greater safety for infusion of vesicant/irritant and hyperosmolar solutions and enable administration of antibiotics, prolonged parenteral nutrition (PPN), and chemotherapy agents. They also involve reduced risk of infection compared to other vascular catheters and are more cost-effective than centrally inserted venous catheters (CICVC). Objectives: To present the results of our team's experience with US-guided and fluoroscopy-positioned PICC placement at the Hospital and Maternidade São Luiz (HMSL) Itaim, Rede D'or, Brazil. Methods: This was a prospective, non-randomized study, conducted from February 2015 to November 2016. The institution's preestablished protocol was followed when vascular access was requested. Indications, prevalent diseases, type of catheter implanted, technical success, and complications related to the catheters were analyzed and inclusion and exclusion criteria are described. Results: A total of 256 vascular accesses were requested, and 236 PICCs (92.1%) and 20 CICVCs (7.9%) were implanted. The main indications were as follows: prolonged antibiotic therapy (52%), PPN (19.3%), and difficult venous access (16%). Technical successes was achieved in 246 catheter placements (96.1%). The right basilic vein was the most common vein punctured for access, in 192 patients (75%), followed by the right brachial vein, in 28 patients (10.9%). Conclusions: Ultrasound-guided and fluoroscopy-positioned PICC placement had a low incidence of complications, reduced infection rates, and proved safe and effective in cases of difficult vascular access. PICCs can be considered the devices of choice for central vascular access


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Catheters , Central Venous Catheters/adverse effects , Fluoroscopy/methods , Prevalence , Prospective Studies , Prostheses and Implants , Surgical Procedures, Operative/methods , Treatment Outcome , Upper Extremity , Vena Cava, Superior , Venous Thrombosis/complications , Venous Thrombosis/diagnosis
11.
Rev. méd. Minas Gerais ; 27: [1-5], jan.-dez. 2017.
Article in Portuguese | LILACS | ID: biblio-980282

ABSTRACT

A trombose venosa profunda (TVP) é a causa mais frequente e mais evitável de óbitos intra-hospitalares em todo o mundo. Descreve-se, neste relato, paciente feminina, de 43 anos de idade, que desenvolveu TVP em membro inferior esquerdo sem, aparentemente, fatores de risco associados. O diagnóstico de TVP aguda em mulher adulta ou adulta-jovem, sobretudo à esquerda, inclui a possibilidade de se associar com a variação anatômica da Síndrome de May-Thurner, o que torna menos adequado o seu tratamento isolado e conservador com anticoagulantes, uma vez que não aborda a sua causa base. Nesta situação clinico-cirúrgica, é necessária intervenção cirúrgica para retirar a compressão mecânica extrínseca da veia ilíaca comum esquerda pela artéria ilíaca comum direita, como revelada neste relato, por intermédio da angioplastia transluminal percutânea com colocação de stent auto-expansível. Este relato alerta para a importância da busca de diagnóstico etiopatogênico correto para a decisão terapêutica apropriada, o que permite a abordagem mais efetiva e condizente com a melhor recuperação e retorno à higidez. (AU)


Deep venous thrombosis (DVT) is the most frequent and most preventable cause of in-hospital deaths worldwide. We described in this report a 43-year-old female patient who developed DVT in the lower left limb without apparently associated risk factors. The diagnosis of acute DVT in an adult or young adult woman, especially on the left, includes the possibility of being associated with the anatomical variation of the May-Thurner Syndrome, which makes her isolated and conservative treatment with anticoagulants less suitable, because does not address its underlying cause. In this clinical-surgical situation, surgical intervention is required to remove the extrinsic mechanical compression of the left common iliac vein by the common iliac artery, as revealed in this report, through percutaneous transluminal angioplasty with selfexpanding stent placement. This report alerts to the importance of the correct etiopathogenic diagnostic search for the appropriate therapeutic decision, which allows the most effective approach, consistent with the best recovery and return to health. (AU)


Subject(s)
Humans , Female , Middle Aged , Venous Thrombosis/diagnosis , May-Thurner Syndrome/diagnosis , Surgical Procedures, Operative , Therapeutics , Stents , Venous Thrombosis
12.
S. Afr. med. j. (Online) ; 107(10): 859-863, 2017. tab
Article in English | AIM, AIM | ID: biblio-1271142

ABSTRACT

Background. Venous thromboembolic disease (VTE) is a leading cause of morbidity and mortality worldwide. HIV and tuberculosis (TB) infections have an aetiological association with VTE. Implementation of national HIV and TB programmes in South Africa (SA) has changed the burden of these two conditions, with resultant effects on VTE prevalence. Furthermore, with the increased use of direct oral anticoagulants (DOACs), baseline thrombosis data are needed to evaluate the effect of these new agents.Objectives. To determine real-life baseline VTE characteristics in a pre-DOAC era, and to document the association of HIV and TB infections with VTE.Methods. This was a single-centre prospective cohort study performed in a quaternary care centre at Charlotte Maxeke Johannesburg Academic Hospital, SA. Key inclusion criteria included signed informed consent by adults (≥18 years) with a new episode of thrombosis. Procedures included physical examination, thrombosis risk factor assessment, duplex Doppler examination, thrombophilia screening, inpatient treatment and outpatient follow-up.Results. Ninety-nine participants with confirmed thrombosis met the inclusion criteria. Participants were predominantly black (79.8%) and female (64.6%), with a median age of 46 (interquartile range (IQR) 38 - 57) years. The prevalences of HIV and TB were 53.0% and 21.2%, respectively. The most common risk factors for thrombosis were TB (17.2%) and malignancies (14.1%). Thrombophilia screening had a low diagnostic yield. The median time to target international normalised ratio during hospitalisation was 5.5 (IQR 4.0 - 7.0) days and the median duration of hospitalisation was 9 (IQR 7 - 11) days. The overall mortality rate in the cohort at 3 months post hospitalisation was 12.1%.Conclusions. This prospective study provides real-life data on thrombosis diagnosis and management at a quaternary public healthcare facility, providing a valuable baseline against which the effect of new DOAC anticoagulants can be assessed. Further research is required to clarify the aetiological association between thrombosis and HIV and TB


Subject(s)
Coinfection , HIV Infections , Hospitalization , Prevalence , South Africa , Tuberculosis , Venous Thrombosis/diagnosis
13.
Article in French | AIM, AIM | ID: biblio-1271915

ABSTRACT

INTRODUCTION:Les thromboses veineuses (TV) constituent une pathologie fréquente et potentiellement grave. Les facteurs de risques ou étiologiques sont multiples. Malgré les nombreuses recommandations internationales sur la prophylaxie, les incidences hospitalières de cette pathologie restent toujours élevées. METHODOLOGIE:Nous avions mené une étude rétrospective et descriptive au service de cardiologie de l'hôpital général de Grand Yoff de Dakar entre janvier 2006 et décembre 2014 soit une période de 9 ans. Tous les dossiers de malades hospitalisés pour thrombose veineuse (TV) confirmée à l'imagerie ont été recensés. Les paramètres étudiés étaient les données épidémiologiques, diagnostiques, thérapeutiques et évolutives. Les données ont été analysées avec le logiciel EPI INFO 6.0. Le seuil de significativité était retenu pour une valeur de p<0,05.RESULTATS:Nous avions colligés 148 cas de thromboses veineuses. La prévalence était de 2,78%. Le sex ratio H/F était de 0,51. L'âge moyen était de 51 ans ± 19,22. La symptomatologie était dominée par le tableau de grosse jambe inflammatoire gauche dans 89 cas (60 %). L'écho-Doppler veineuse objectivait une prédominance des TV au niveau du réseau veineux profond dans 123 cas (83,7%). Les facteurs de risque retrouvés étaient dominés outre l'âge supérieur ou égal à 60 ans (38,5%), la prise de pilules oestro-progestatives (13%) et le tabagisme (9,5%). Les patients avaient bénéficié d'un traitement à base d'héparine de bas poids moléculaire associé dès le 1er jour à un antivitamine K (acénocoumarol) (98%). L'évolution était favorable chez 121 patients (82,4%). La mortalité globale était de 2,7% soit 4 patients.CONCLUSION:Les thromboses veineuses deviennent relativement fréquentes dans nos hôpitaux. Dans notre étude, elle était plus fréquente chez les femmes et les sujets jeunes et plus souvent liée aux facteurs médicaux


Subject(s)
Cardiology Service, Hospital , Disease Progression , Senegal , Venous Thrombosis/diagnosis , Venous Thrombosis/epidemiology , Venous Thrombosis/etiology , Venous Thrombosis/therapy
14.
Medicina (B.Aires) ; 75(2): 95-98, abr. 2015. ilus
Article in Spanish | LILACS | ID: lil-750521

ABSTRACT

El síndrome de Hughes-Stovin es una entidad infrecuente caracterizada por trombosis venosa profunda y aneurismas de la arteria pulmonar, siendo su etiología y patogenia desconocida. Algunos autores la consideran una variante de la enfermedad de Behcet. Su curso natural es generalmente fatal. Se presenta con tos, disnea, hemoptisis, dolor torácico y fiebre. El tratamiento es con esteroides y agentes citotóxicos hasta la cirugía. Presentamos el caso de un hombre de 41 años que consultó por disnea, hemoptisis y dolor torácico, llegándose al diagnóstico de trombosis venosa profunda de miembro inferior derecho, trombo-embolismo de pulmón y aneurismas de arterias pulmonares. Recibió tratamiento con corticoides en altas dosis y 6 pulsos de ciclofosfamida de 1 gramo durante 6 meses, con regresión completa de los aneurismas y de la sintomatología.


The Hughes-Stovin syndrome is a rare entity characterized by deep vein thrombosis and pulmonary artery aneurysms of unknown etiology and pathogenesis. Some authors considered a variant of Behcet's disease. Its natural course is usually fatal. The symptoms are cough, dyspnea, hemoptysis, chest pain and fever. The treatment goes from steroids and cytotoxic agents to surgery. We present the case of a 41 year old man who shows dyspnea, hemoptysis, and chest pain leading to the diagnosis of deep venous thrombosis of the right leg, lung thromboembolism and pulmonary artery aneurysms. He was treated with high-dose corticosteroids and 6 cyclophosphamide pulses of 1 gram each per 6 months with complete regression of aneurysms and symptomatology.


Subject(s)
Humans , Male , Adult , Pulmonary Artery , Pulmonary Embolism/diagnosis , Aneurysm, Ruptured/diagnosis , Venous Thrombosis/diagnosis , Syndrome , Behcet Syndrome/diagnosis , Hemoptysis/etiology
15.
Egyptian Journal of Hospital Medicine [The]. 2015; 61 (October): 363-370
in English | IMEMR | ID: emr-173893

ABSTRACT

Background: Diagnosis of venous thromboembolic disease [deep venous thrombosis and pulmonary embolism] is often inaccurate because signs and symptoms are nonspecific. Numerous clinical management trials using D-dimer which is one of the coagulation markers have shown that it has a sufficient specificity to assist in the diagnosis of venous thromboembolic disease


Aim of the work: This study was done to validate the utility of D-dimer as a diagnostic biomarker for DVT using a higher cutoff values which may improve the test specificity


Material and method: In this retrospective chart review study, we reviewed the hospital records of all patients for whom D-dimer assay was done in King Abdul Aziz Specialist Hospital, Al Taif - Saudi Arabia from January 2011 to October 2013. The study involved 141 individuals; 25 who were proved to be normal were chosen to serve as control group [Group I], 61 patients who were positive for DVT by duplex scanning [Group II] and 55 patients who had symptoms of DVT but showed negative results on duplex ultrasound[group III]


Results: The demographic data revealed statistically insignificant difference between all studied groups. No significant differences were detected between the studied groups, except for hemoglobin level which was significantly lower in patients of groups II and III than in control group. However, highly significant differences were detected between different studied groups as regards D-dimer. Analysis of the receiver operator characteristic [ROC] curve to establish the cutoff level of the studied marker in the diagnosis of DVT, verified that D-dimer value of 0.92 mg/L can accurately differentiate patients who were positive for DVT on duplex scanning from control group. Level of 2.81 mg/L for D-dimer was considered as a cutoff point that can differentiate patients who were duplex negative and free from thrombosis from those who eventually developed thrombosis


Conclusion: This study suggests the importance of the use of modified D-dimer cut-off values that can safely differentiate patients who are free from venous thromboembolic disease from others who are positive for the disease sparing patients the unnecessary risks of anticoagulation. In addition it can detect the patients who will eventually develop thrombosis regardless their primary duplex ultrasound scanning results, so, they could receive anticoagulation treatment


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Venous Thromboembolism/diagnosis , Acute Disease , Biomarkers , Venous Thrombosis/diagnosis , Retrospective Studies
16.
Article in English | WPRIM | ID: wpr-127328

ABSTRACT

BACKGROUND: The purpose of the current study was to investigate the incidence of preoperative deep vein thrombosis (DVT) after hip fractures in Korea. METHODS: In this prospective study, we enrolled 152 Korean geriatric patients who had suffered hip fractures due to a simple fall and were hospitalized between January 2013 and December 2013. There were 52 male and 100 female patients, and their mean age was 78.2 years. There were 96 trochanteric fractures and 56 femoral neck fractures. All patients were examined for DVT: 26 by ultrasonography and 126 by computed tomography venography. The patients having DVT underwent inferior vena cava filter insertion before the surgical intervention. RESULTS: Preoperatively, none of the patients had any signs or symptoms of DVT; however, 4 patients were identified as having asymptomatic DVT. The overall incidence of DVT was 2.6% (4/152). The mean time to arrival at emergency room after injury was 32.6 hours. Mean time elapsed to undergo surgery after hospitalization was 24.9 hours. The average time to hospitalization after injury was 237 hours for patients with DVT versus 27.5 hours for patients without DVT. DVT developed within 72 hours in two of the 137 patients (1.4%) and after 72 hours in two of the remaining 15 patients (13.3%) hospitalized. CONCLUSIONS: While the preoperative incidence of DVT after hip fractures was relatively low (2.6%) in the Korean geriatric population, we confirmed that getting no treatment within 72 hours after injury increased the incidence of DVT. Thus, we conclude from this study that a workup for DVT should be considered in cases where admission or surgery has been delayed for more than 72 hours after injury.


Subject(s)
Aged , Aged, 80 and over , Female , Hip Fractures/complications , Humans , Incidence , Male , Prospective Studies , Republic of Korea/epidemiology , Time-to-Treatment , Venous Thrombosis/diagnosis
17.
Rev. cuba. hematol. inmunol. hemoter ; 30(4): 381-386, oct.-dic. 2014.
Article in Spanish | LILACS | ID: lil-735298

ABSTRACT

La policitemia vera es un síndrome mieloproliferativo crónico resultado de la proliferación anormal de la célula madre pluripotente, que da lugar a una hematopoyesis clonal con predominio de hiperplasia eritroide sobre el resto de las líneas hematopoyéticas. Como en otros síndromes mieloproliferativos, se observan complicaciones trombóticas y hemorrágicas, que son causa de morbimortalidad en este grupo de pacientes. La asociación de policitemia vera y estados trombofílicos no es frecuente y cuando aparece aumenta la tendencia a la formación de trombos. Por otro lado, las trombofilias son un grupo heterogéneo de condiciones asociadas a un mayor riesgo de aparición de trombosis arteriales y venosas en las que existen un grupo de factores de riesgo. En este trabajo se presenta un paciente masculino de 50 años con el diagnóstico de policitemia vera de 12 años de evolución, que ha llevado tratamiento con hidroxiurea e interferón alfa recombinante. Durante los dos últimos años comenzó a presentar cuadros de hemorragias recurrentes en ambos miembros inferiores y superiores y además presentó una trombosis venosa profunda por lo que se le realizaron estudios de hemostasia y se detectó una disminución significativa de la actividad de las proteínas C y S, asociación descrita de forma infrecuente, concomitante con alteraciones de la función plaquetaria. Con la presentación de este caso se demuestra la importancia de pesquisar la presencia de estados trombofílicos asociados a procesos hematológicos malignos...


Polycythemia vera is a chronic myeloproliferative syndrome resulting from abnormal proliferation of the pluripotent stem cell, giving rise to a clonal hematopoiesis, with predominant erythroid hyperplasia over other hematopoietic lines. In this as in other myeloproliferative syndromes thrombotic and hemorrhagic complications are observed, which are cause of morbidity and mortality in this group of patients. The association of polycythemia vera and thrombophilic states is infrequent and when it appears tendency of thrombus formation is increased. Furthermore, thrombophilias are a heterogeneous group of conditions associated to an increased risk of arterial and venous thrombosis where a group of risk factors exists. We present a 50 year-old male patient with a diagnosis of polycythemia vera 12 years ago, who has been treated with hydroxyurea and recombinant alpha interferon. During the last two years he started suffering recurrent bleeding episodes in both upper and lower limbs also presenting a deep vein thrombosis. Hemostasis studies were performed and a significant reduction in the activity of proteins C and S were detected, which association is infrequently described, concomitant with alterations of platelet function. This case demonstrates the importance of searching for the presence of thrombophilic states associated to hematological malignancies...


Subject(s)
Humans , Male , Middle Aged , Polycythemia Vera/complications , Polycythemia Vera/diagnosis , Venous Thrombosis/diagnosis , Venous Thrombosis/prevention & control
18.
Rev. méd. Chile ; 142(11): 1478-1481, nov. 2014. ilus
Article in Spanish | LILACS | ID: lil-734885

ABSTRACT

Pulmonary artery sarcoma is an uncommon entity with high mortality. Its clinical presentation is usually indistinguishable from pulmonary embolism, which leads to a significant delay in diagnosis. Hughes-Stovin syndrome is characterized by venous thrombosis and aneurysms of the pulmonary or bronchial artery. We report a 59 year-old female with a history of recurrent pulmonary embolism. In the last thromboembolic episode a pulmonary artery aneurysm was found on a CT scan. The patient was operated performing a left inferior lobectomy. The patient died five days after surgery and the pathological examination of the surgical piece revealed a pulmonary artery sarcoma.


Subject(s)
Female , Humans , Middle Aged , Aneurysm/diagnosis , Pulmonary Artery , Sarcoma/diagnosis , Vascular Neoplasms/diagnosis , Venous Thrombosis/diagnosis , Diagnosis, Differential , Fatal Outcome , Syndrome
19.
Rev. chil. obstet. ginecol ; 79(5): 429-434, oct. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-729407

ABSTRACT

La trombosis venosa cerebral es una enfermedad poco frecuente, pero de pronóstico potencialmente grave. Debido a los cambios hemostáticos durante la gestación, es una patología que puede asociarse al embarazo. Presenta un amplio rango de signos y síntomas. El diagnóstico y tratamiento precoz mejoran el pronóstico. Presentamos el caso de una mujer de 30 años, que en la semana 8 de gestación acude a Urgencias por cefalea intensa y cuya resonancia magnética reveló una trombosis venosa cerebral. La paciente presentó un segundo episodio en la semana 33, a pesar del correcto tratamiento anticoagulante recibido.


Cerebral venous thrombosis is a rare disease, but with a potentially serious prognosis. It is a condition that can be associated with pregnancy because of the hemostatic changes during gestation. It has a wide range of signs and symptoms. Early diagnosis and treatment improve prognosis. We report the case of a 30-year-old woman, at week 8 of pregnancy, who came to the emergency department for severe headache and whose magnetic resonance imaging revealed a cerebral venous thrombosis. The patient had a second episode at week 33, despite correct anticoagulation received.


Subject(s)
Humans , Adult , Pregnancy Complications, Cardiovascular , Intracranial Thrombosis/diagnosis , Intracranial Thrombosis/drug therapy , Venous Thrombosis/diagnosis , Venous Thrombosis/drug therapy , Anticoagulants/therapeutic use , Heparin/therapeutic use
20.
Article in Portuguese | LILACS | ID: biblio-882899

ABSTRACT

Este trabalho tem por objetivo facilitar o diagnóstico da trombose venosa de membros inferiores, diferenciando-a entre superficial e profunda, para que seja instituído o tratamento mais adequado para cada caso.


This article aims to facilitate the diagnosis of lower extremity venous thrombosis, differentiating between superficial and deep, and choose appropriate treatment for each case to be imposed.


Subject(s)
Thrombophlebitis/diagnosis , Venous Thrombosis/diagnosis , Emergency Medical Services , Lower Extremity
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