Subject(s)
Chagas Disease/diagnostic imaging , Chagas Disease/epidemiology , Ischemic Attack, Transient/diagnostic imaging , Ischemic Attack, Transient/epidemiology , Trypanosoma brucei brucei , Adult , Brazil/epidemiology , Cohort Studies , Female , Humans , Ischemic Attack, Transient/parasitology , Male , Middle Aged , Prospective Studies , UltrasonographyABSTRACT
INTRODUCTION: Chagas disease (CD) is associated with stroke, which can result in significant long-term disability. Stroke has also been associated with depressive symptoms, which affect functional performance and quality of life (QOL). Few data are available on the effect of chagasic stroke on functional performance and QOL. OBJECTIVES: This study aimed to investigate the correlation of stroke disability and depressive symptoms with functional performance and QOL in chagasic stroke patients. METHODS: In this cross-sectional study, stroke sequelae were assessed using the Modified Rankin Stroke Scale (MRSS), depressive symptoms using the Beck Depression Inventory (BDI), functional performance using the Barthel Index (BI), and QOL using the WHOQOL-BREF. RESULTS: Twenty-one patients with CD and a previous diagnosis of stroke were included. There was a correlation between the MRSS score and the BI score (r=-0.663, p=0.003), but not the scores of the WHOQOL-BREF subscales. The BDI score was correlated with the WHOQOL-BREF subscale scores (Physical: r=-0.733, p=0.001; Psychological: r=-0.581, p=0.012; Social: r=-0.713, p=0.001; Environmental: r=-0.659, p=0.003). However, the BDI score was not associated with the BI score (r=0.279, p=0.262). CONCLUSIONS: QOL in patients with CD appears to be influenced more by depressive symptoms than by the motor-associated consequences of stroke. Conversely, motor sequelae impair the functionality of the patient more than depressive symptoms.
Subject(s)
Chagas Disease/psychology , Depression/psychology , Stroke/psychology , Activities of Daily Living , Adult , Aged , Aged, 80 and over , Chagas Disease/complications , Cross-Sectional Studies , Disability Evaluation , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Pilot Projects , Psychiatric Status Rating Scales , Quality of Life , Sample Size , Stroke/etiologyABSTRACT
A ruptura dos aneurismas aorto-ilíacos para a veia ilíaca ou veia cava é uma complicação pouco comum. A hipertensão venosa leva a vários sinais e sintomas, o que dificulta o diagnóstico pré-operatório, tais como edema do membro inferior, dispnéia, hematúria, sinais de insuficiência renal ou cardíaca. Sopro abdominal é a chave do diagnóstico clínico, associado à massa pulsátil e dor abdominal. O reconhecimento da fístula arteriovenosa no pré-operatório é importante para o planejamento cirúrgico. Relatamos um caso de aneurisma da artéria ilíaca comum e interna direita associado a fístula para veia ilíaca comum, cursando, inicialmente, com edema do membro inferior direito e dispnéia, o que levou ao diagnóstico incorreto de trombose venosa profunda.
Rupture of aortoiliac aneurysms into the iliac vein or vena cava is an uncommon complication. Many signs and symptoms develop as a result of venous hypertension, which makes preoperative diagnosis difficult, such as leg edema, dyspnea, hematuria, signs of renal or cardiac insufficiency. Abdominal bruit, associated with pulsatile mass and abdominal pain, is the key for clinical diagnosis. Preoperative recognition of arteriovenous fistula is important for surgical planning. We report a case of right internal and common iliac artery aneurysm associated with fistula into the common iliac vein. Initial symptoms were right leg edema and dyspnea, which induced to the incorrect diagnosis of deep vein thrombosis.
Subject(s)
Humans , Male , Aged , Iliac Aneurysm/complications , Iliac Aneurysm/diagnosis , Aneurysm, Ruptured/complications , Aneurysm, Ruptured/diagnosis , Arteriovenous Fistula/complications , Arteriovenous Fistula/diagnosis , Heart Failure/complications , Heart Failure/diagnosisABSTRACT
O pseudo-aneurisma (PSA) após cateterização femoral tem sido diagnosticado com regularidade em serviços com grande movimento de intervenções percutâneas, com incidência variando de 0,05 a 6 por cento. PSA femorais pequenos podem ser acompanhados até a resolução espontânea. As opções de tratamento são: compressão guiada por ultra-som, injeção de trombina para trombose do PSA e tratamento cirúrgico. A injeção percutânea de trombina tem a vantagem de ser um procedimento indolor e rápido. Podem ser utilizados trombina isolada ou preparados contendo trombina associada a fibrinogênio e fatores de coagulação. A experiência inicial dos autores de cinco casos tratados com injeção de adesivo tissular contendo trombina mostrou resultado satisfatório em quatro; um caso necessitou tratamento cirúrgico. Não houve sucesso com uso isolado de trombina humana, porém, ocorreu trombose imediata após injeção de preparado de trombina associada a fibrinogênio/fator XIII. Neste artigo, são discutidas as opções de tratamento dos PSA femorais e a técnica do uso de trombina percutânea.
