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1.
Clinics (Sao Paulo) ; 76: e1802, 2021.
Article in English | MEDLINE | ID: mdl-33503171

ABSTRACT

OBJECTIVES: Although the practice of physical exercise in patients with intermittent claudication (IC) is often encouraged, adherence is low. The difficulty in performing physical training may be related to the psychological characteristics of patients with claudication. To verify the association between anxiety and depression symptoms and barriers to physical exercise and walking capacity in patients with IC. METHODS: One-hundred and thirteen patients with a clinical diagnosis of IC were included in the study. Patients underwent clinical evaluation by a vascular surgeon, answered the Beck Depression Inventory, and Beck Anxiety Inventory tests were applied by the psychologist. The patients performed the 6-minute test and reported their barriers to physical activity practice in a questionnaire. RESULTS: Patients with signs of depression had a shorter pain-free walking distance (p=0.015) and total walking distance (p=0.035) compared to patients with no signs of depression. Pain-free walking distance (p=0.29) and total walking distance (p=0.07) were similar between patients with and without signs of anxiety. Patients with symptoms of moderate to severe depression reported more barriers to physical activity practice compared to patients without signs of depression. CONCLUSION: Symptoms of anxiety and depression are prevalent among patients with peripheral arterial occlusive disease (PAD). Depression symptoms are associated with personal barriers to exercise, while anxiety symptoms are not. The main barriers to physical activity among patients with IC are exercise-induced pain and the presence of other diseases.


Subject(s)
Depression , Intermittent Claudication , Anxiety , Gait , Humans , Walking
2.
Clinics ; 76: e1802, 2021. tab, graf
Article in English | LILACS | ID: biblio-1153948

ABSTRACT

OBJECTIVES: Although the practice of physical exercise in patients with intermittent claudication (IC) is often encouraged, adherence is low. The difficulty in performing physical training may be related to the psychological characteristics of patients with claudication. To verify the association between anxiety and depression symptoms and barriers to physical exercise and walking capacity in patients with IC. METHODS: One-hundred and thirteen patients with a clinical diagnosis of IC were included in the study. Patients underwent clinical evaluation by a vascular surgeon, answered the Beck Depression Inventory, and Beck Anxiety Inventory tests were applied by the psychologist. The patients performed the 6-minute test and reported their barriers to physical activity practice in a questionnaire. RESULTS: Patients with signs of depression had a shorter pain-free walking distance (p=0.015) and total walking distance (p=0.035) compared to patients with no signs of depression. Pain-free walking distance (p=0.29) and total walking distance (p=0.07) were similar between patients with and without signs of anxiety. Patients with symptoms of moderate to severe depression reported more barriers to physical activity practice compared to patients without signs of depression. CONCLUSION: Symptoms of anxiety and depression are prevalent among patients with peripheral arterial occlusive disease (PAD). Depression symptoms are associated with personal barriers to exercise, while anxiety symptoms are not. The main barriers to physical activity among patients with IC are exercise-induced pain and the presence of other diseases.


Subject(s)
Humans , Depression , Intermittent Claudication , Anxiety , Walking , Gait
3.
J Aging Phys Act ; 27(5): 719-724, 2019 09 01.
Article in English | MEDLINE | ID: mdl-30747555

ABSTRACT

This cross-sectional study compared physical activity levels and barriers between 212 men and women with symptomatic peripheral artery disease. Physical activity was objectively measured by an accelerometer. Barriers to physical activity were obtained using a validated questionnaire. Women reported higher amounts of light physical activity (p < .001) and lower moderate-vigorous physical activity (p < .001) than men. Women more often reported barriers such as "not having anyone to accompany" (p = .006), "lack of money" (p = .018), "fear of falling or worsening the disease" (p = .010), "lack of security" (p = .015), "not having places to sit when feeling leg pain" (p = .021), and "difficulty in getting to a place to practice physical activity" (p = .015). In conclusion, women with symptomatic peripheral artery disease presented with lower amounts of moderate-vigorous activity and more barriers to activity than men. Strategies to minimize the barriers, including group actives and nonpainful exercises, are recommended for women with peripheral artery disease.


Subject(s)
Exercise , Peripheral Arterial Disease/therapy , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Exercise/psychology , Exercise Therapy/methods , Female , Humans , Male , Middle Aged , Peripheral Arterial Disease/physiopathology , Sex Factors
4.
Ann Vasc Surg ; 54: 176-184, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30103051

ABSTRACT

BACKGROUND: Atherosclerosis and abdominal aortic aneurysms (AAAs) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines, and the perivascular fat has a local effect that could contribute to diseases of the abdominal aorta. Although the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results. The aim of this study was to analyze the correlation between central obesity and the presence of abdominal aortic diseases using computed tomography. METHODS: Six hundred thirty-nine consecutive patients classified into 3 groups (AAA, aortic atherosclerotic occlusive disease (AAOD), and without aortic disease [control group]) who underwent computed tomography had the aorta diameter, the visceral fat area (VFA), and the subcutaneous fat area (SFA) measured at the level of third and fourth lumbar vertebrae. RESULTS: VFA showed no difference between the groups. SFA was lower in atherosclerotic group (AAOD) than control (P < 0.01 in general and P < 0.04 in male). In AAA group, we found in men that the first tertile of aorta diameter had higher VFA than third tertile (P = 0.02). CONCLUSIONS: There was no difference in VFA between patients in AAA, AAOD, and without aortic disease groups. In men with aneurysm, there was an inverse relationship between VFA and aortic diameter. In AAOD, visceral to subcutaneous ratio is higher due to lower SFA.


Subject(s)
Aorta/anatomy & histology , Aortic Aneurysm, Abdominal/etiology , Aortic Diseases/etiology , Atherosclerosis/etiology , Intra-Abdominal Fat/anatomy & histology , Obesity, Abdominal/complications , Adiposity , Aged , Aorta/diagnostic imaging , Aorta/pathology , Aortic Diseases/pathology , Case-Control Studies , Female , Humans , Male , Middle Aged , Risk Factors , Sex Factors , Tomography, X-Ray Computed
5.
Ann Vasc Surg ; 52: 147-152, 2018 Oct.
Article in English | MEDLINE | ID: mdl-29793014

ABSTRACT

BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations. RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048). CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.


Subject(s)
Intermittent Claudication/diagnosis , Microcirculation , Muscle Contraction , Muscle, Skeletal/blood supply , Muscle, Skeletal/metabolism , Oxygen Consumption , Peripheral Arterial Disease/diagnosis , Walk Test , Walking , Aged , Exercise Tolerance , Female , Humans , Intermittent Claudication/metabolism , Intermittent Claudication/physiopathology , Leg , Male , Middle Aged , Peripheral Arterial Disease/metabolism , Peripheral Arterial Disease/physiopathology , Predictive Value of Tests , Time Factors
6.
Ann Vasc Surg ; 40: 239-242, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27932292

ABSTRACT

BACKGROUND: We analyze the effects of graduated compression stoking (GCS) on walking capacity and oxygen saturation in intermittent claudication (IC) patients. METHODS: Eighteen patients with IC performed the 6-minute walking test in 2 conditions in random order: GCS or placebo sock. Onset claudication distance and total walking distance were obtained. The calf muscle oxygen saturation was continuously monitored before, during, and after 6-minute walk test. Comparisons of the walking capacity and StO2 parameters between GCS and placebo conditions were analyzed by Wilcoxon rank-sum test. RESULTS: The onset claudication distance (GCS: 120 ± 99 meters vs. placebo: 150 ± 126 meters; P = 0.798) and total walking distance (GCS: 330 ± 108 meters vs. placebo: 324 ± 60 meters; P = 0.130) were similar between conditions. There were no differences in StO2 parameters between conditions (P > 0.05). CONCLUSIONS: GCS does not decrease walking performance and calf muscle oxygenation saturation during 6-minute walk test in patients with IC.


Subject(s)
Exercise Tolerance , Intermittent Claudication/therapy , Muscle, Skeletal/blood supply , Oxygen/blood , Stockings, Compression , Walk Test , Aged , Biomarkers/blood , Brazil , Equipment Design , Female , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Male , Middle Aged , Predictive Value of Tests , Recovery of Function , Time Factors , Treatment Outcome , Walking
7.
J Cardiopulm Rehabil Prev ; 36(5): 358-67, 2016.
Article in English | MEDLINE | ID: mdl-26959497

ABSTRACT

PURPOSE: Maximal and submaximal parameters assessed during treadmill tests are used to prescribe exercise training and assess exercise-induced adaptations in patients with intermittent claudication (IC). Although reproducibility of maximal parameters is well documented, the reproducibility of submaximal is not clear. The aim of this study was to identify the reproducibility (reliability and agreement) of heart rate (HR) and oxygen uptake ((Equation is included in full-text article.)O2) measured at the anaerobic (AT) and the pain (PT) thresholds assessed during a maximal test in patients with IC. METHODS: Twenty male patients with IC underwent 2 cardiopulmonary treadmill tests to maximal pain. The HR and (Equation is included in full-text article.)O2 at the AT and PT were identified, and differences between repeat tests were compared. Reliability was determined by intraclass coefficient correlation (ICC). Agreement was assessed by coefficient of variation (CV), standard error of measurement (SEM), smallest detectable difference (SDD), and limits of agreement (LOA). RESULTS: The (Equation is included in full-text article.)O2 at AT and PT exhibited moderate reliability and moderate/good agreement (ICC = 0.73 and 0.70; CV = 9.6% and 11.1%, respectively). The HR at the AT and PT exhibited high reliability and good agreement (ICC = 0.87 and 0.92; SEM = 3.9 and 3.2 bpm; SDD = 10.8 and 8.8 bpm, respectively). The LOA for (Equation is included in full-text article.)O2 at AT and PT were ≤20% and for HR ≤11 bpm. CONCLUSIONS: The (Equation is included in full-text article.)O2 and HR measured at the AT and PT were moderately to highly reproducible in male patients with IC. The HR and (Equation is included in full-text article.)O2 at AT and PT may be used to establish training intensity and evaluate training effectiveness for these patients in clinical practice and research.


Subject(s)
Anaerobic Threshold , Exercise Test , Intermittent Claudication/physiopathology , Pain Threshold , Aged , Heart Rate , Humans , Male , Middle Aged , Oxygen Consumption , Reproducibility of Results
8.
Arq. bras. cardiol ; 106(1): 49-55, Jan. 2016. tab, graf
Article in Portuguese | LILACS | ID: lil-771050

ABSTRACT

Abstract Background: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. Objective: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. Methods: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test–retest reliability with a seven-day interval between the two questionnaire applications were calculated. Results: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. Conclusion: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.


Resumo Fundamento: O questionário Walking Estimated-Limitation Calculated by History (WELCH) foi proposto para avaliar o comprometimento da marcha em pacientes com claudicação intermitente (CI), apresentando propriedades psicométricas satisfatórias. No entanto, não há ainda uma versão disponível em português brasileiro, o que reduz seu uso em pacientes brasileiros. Objetivo: Analisar as propriedades psicométricas de uma versão do WELCH traduzida para o português brasileiro em pacientes brasileiros com CI. Métodos: Oitenta e quatro pacientes com CI participaram do estudo. Após tradução e retrotradução realizadas por dois tradutores independentes, a validade de constructo do WELCH foi analisada através da correlação dos escores do questionário com a capacidade de caminhada obtida com o teste de esteira (protocolo de Gardner). Para determinar a confiabilidade do WELCH, foram calculadas a consistência interna e a confiabilidade teste–reteste com um intervalo de sete dias entre as aplicações dos dois questionários. Resultados: Foram observadas correlações positivas significativas entre o escore WELCH e a distância até início da claudicação (Figura 1A; r = 0,64, p = 0,01) e distância total de caminhada (Figura 1B; r = 0,61, p = 0,01). A consistência interna foi de 0,84, enquanto que o coeficiente de correlação intraclasse entre a avaliação dos questionários foi de 0,84. Não houve diferenças nos escores de WELCH entre as aplicações dos dois questionários. Conclusão: A versão em português brasileiro do WELCH apresenta indicadores adequados de validade e confiabilidade, permitindo seu uso em pacientes brasileiros com CI.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Intermittent Claudication/physiopathology , Surveys and Questionnaires/standards , Translations , Walking/physiology , Ankle Brachial Index , Brazil , Disability Evaluation , Exercise Test/methods , Predictive Value of Tests , Psychometrics , Reproducibility of Results , Statistics, Nonparametric
9.
Arq Bras Cardiol ; 106(1): 49-55, 2016 Jan.
Article in English, Portuguese | MEDLINE | ID: mdl-26647720

ABSTRACT

BACKGROUND: The Walking Estimated-Limitation Calculated by History (WELCH) questionnaire has been proposed to evaluate walking impairment in patients with intermittent claudication (IC), presenting satisfactory psychometric properties. However, a Brazilian Portuguese version of the questionnaire is unavailable, limiting its application in Brazilian patients. OBJECTIVE: To analyze the psychometric properties of a translated Brazilian Portuguese version of the WELCH in Brazilian patients with IC. METHODS: Eighty-four patients with IC participated in the study. After translation and back-translation, carried out by two independent translators, the concurrent validity of the WELCH was analyzed by correlating the questionnaire scores with the walking capacity assessed with the Gardner treadmill test. To determine the reliability of the WELCH, internal consistency and test-retest reliability with a seven-day interval between the two questionnaire applications were calculated. RESULTS: There were significant correlations between the WELCH score and the claudication onset distance (r = 0.64, p = 0.01) and total walking distance (r = 0.61, p = 0.01). The internal consistency was 0.84 and the intraclass correlation coefficient between questionnaire evaluations was 0.84. There were no differences in WELCH scores between the two questionnaire applications. CONCLUSION: The Brazilian Portuguese version of the WELCH presents adequate validity and reliability indicators, which support its application to Brazilian patients with IC.


Subject(s)
Intermittent Claudication/physiopathology , Surveys and Questionnaires/standards , Translations , Walking/physiology , Aged , Ankle Brachial Index , Brazil , Disability Evaluation , Exercise Test/methods , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Psychometrics , Reproducibility of Results , Statistics, Nonparametric
10.
São Paulo; s.n; 2015. [101] p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-871591

ABSTRACT

INTRODUÇÃO: Pré-condicionamento isquêmico remoto (PCIR) é o fenômeno pelo qual curtos períodos de isquemia sub-letal sobre um órgão ou tecido, intercalados com reperfusão do mesmo, conferem a outros órgãos ou tecidos distantes deste, um aumento na capacidade da resistir a episódios subsequentes de isquemia, a qual os mesmos possam ser expostos. Com base nesse fato, testamos a hipótese de que o pré-condicionamento isquêmico remoto em pacientes portadores de claudicação intermitente de membros inferiores poderia aumentar a capacidade de deambulação desses pacientes, extrapolando o conceito do PCIR de aumento da capacidade de preservação da integridade celular frente à isquemia, para a manutenção da função celular, tornando a célula mais apta ao trabalho em situações de privação de oxigênio, geradas pela restrição do fluxo sanguíneo, como ocorre nos pacientes com claudicação intermitente de membros inferiores, durante o exercício. OBJETIVOS: Avaliar se o PCIR aumenta a distância de início de claudicação e/ou a distância total de claudicação em pacientes com doença arterial obstrutiva periférica. MÉTODOS: Foram estudados 52 pacientes ambulatoriais que apresentavam queixa de claudicação intermitente dos membros inferiores, associada a um pulso arterial ausente ou reduzido no membro sintomático e/ou um índice tornozelo-braço <0,90. Estes pacientes foram randomizados em três grupos (A, B e C). Todos os pacientes foram submetidos a dois testes de caminhada em esteira de acordo com o protocolo de Gardner. O grupo A fez o primeiro teste de esteira sem o pré-condicionamento isquêmico remoto e, após 7 dias, foi submetido a um novo teste de esteira, agora precedido pelo pré-condicionamento isquêmico remoto. O grupo B foi submetido ao pré-condicionamento isquêmico remoto antes do primeiro teste de esteira e, após 7 dias, realizou novo teste de esteira, agora sem o pré-condicionamento isquêmico remoto. Já no Grupo C (grupo controle), ambos os testes de esteira foram...


INTRODUCTION: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. Extrapolating the RIPC concept of increasing the preservation of cell integrity capability against ischemia, for the maintenance of cellular function, making the cell more able to work in oxygen deprivation generated by the restriction of blood flow, as occurs in patients with intermittent claudication of the lower limbs during exercise, we hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. OBJECTIVES: To test this hypothesis, we performed gait tests in patients with claudication with and without prior RIPC and then compared the initial claudication distance (ICD) and the total walking distance (TWD). METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index < 0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A and C showed an increase in the initial claudication distance in the second test compared to the first test. Group A had a statistically significant increase, compared with C group (control group). With respect...


Subject(s)
Humans , Male , Middle Aged , Aged , Atherosclerosis , Cell Hypoxia , Intermittent Claudication , Ischemic Preconditioning , Peripheral Arterial Disease , Reperfusion
11.
Ann Vasc Surg ; 28(3): 640-3, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24405772

ABSTRACT

BACKGROUND: In patients with peripheral arterial disease, metabolic syndrome is associated with less favorable evolution of intermittent claudication. METHODS: The aims of this study were to determine the prevalence of metabolic syndrome in claudicant patients using the IDF and the NCEP-ATPIII criteria, and to assess the level of agreement between the two definitions. RESULTS: In this cross-sectional study, 200 consecutive patients with intermittent claudication (65% male) were classified with or without metabolic syndrome according both criteria. The kappa coefficient was used to assess the level of agreement. Prevalence of metabolic syndrome was 60.5% when using the NCEP-ATPIII definition and 66.5% when using the IDF definition (P = 0.088). Among men, the prevalence of MetS was 55.4% according to the NCEP-ATPIII and 63.1% according to the IDF (P = 0.110) and, among women, 70.0% according to the NCEP-ATPIII and 72.9% according to the IDF (P = 0.754). CONCLUSION: Although the prevalence rates were similar, the reliability analysis showed that the agreement was substantial only among women and just moderate in the total population and among men.


Subject(s)
Health Status Indicators , Intermittent Claudication/epidemiology , Metabolic Syndrome/diagnosis , Metabolic Syndrome/epidemiology , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Intermittent Claudication/diagnosis , Male , Middle Aged , Predictive Value of Tests , Prevalence , Reproducibility of Results , Risk Factors , Sex Factors
12.
Clinics (Sao Paulo) ; 68(4): 495-9, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23778346

ABSTRACT

OBJECTIVE: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A showed a significant increase in the initial claudication distance in the second test compared to the first test. CONCLUSION: RIPC increased the initial claudication distance in patients with intermittent claudication; however, RIPC did not affect the total walking distance of the patients.


Subject(s)
Intermittent Claudication/therapy , Ischemic Preconditioning/methods , Walking/physiology , Aged , Exercise Test , Female , Humans , Intermittent Claudication/physiopathology , Male , Middle Aged , Time Factors , Treatment Outcome
13.
Clinics ; 68(4): 495-499, abr. 2013. tab, graf
Article in English | LILACS | ID: lil-674245

ABSTRACT

OBJECTIVE: Remote ischemic preconditioning (RIPC) is a phenomenon in which a short period of sub-lethal ischemia in one organ protects against subsequent bouts of ischemia in another organ. We hypothesized that RIPC in patients with intermittent claudication would increase muscle tissue resistance to ischemia, thereby resulting in an increased ability to walk. METHODS: In a claudication clinic, 52 ambulatory patients who presented with complaints of intermittent claudication in the lower limbs associated with an absent or reduced arterial pulse in the symptomatic limb and/or an ankle-brachial index <0.90 were recruited for this study. The patients were randomly divided into three groups (A, B and C). All of the patients underwent two tests on a treadmill according to the Gardener protocol. Group A was tested first without RIPC. Group A was subjected to RIPC prior to the second treadmill test. Group B was subjected to RIPC prior to the first treadmill test and then was subjected to a treadmill test without RIPC. In Group C (control group), both treadmill tests were performed without RIPC. The first and second tests were conducted seven days apart. Brazilian Clinical Trials: RBR-7TF6TM. RESULTS: Group A showed a significant increase in the initial claudication distance in the second test compared to the first test. CONCLUSION: RIPC increased the initial claudication distance in patients with intermittent claudication; however, RIPC did not affect the total walking distance of the patients. .


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Intermittent Claudication/therapy , Ischemic Preconditioning/methods , Walking/physiology , Exercise Test , Intermittent Claudication/physiopathology , Time Factors , Treatment Outcome
14.
Angiology ; 61(8): 784-8, 2010 Nov.
Article in English | MEDLINE | ID: mdl-20395234

ABSTRACT

The metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. Intermittent claudication reflects the presence of peripheral arterial disease (PAD). The aim of this study is to determine the prevalence of the MetS in claudicants and its correlation with age, gender, localization of arterial obstruction, and symptomatic coronary disease. Patients (n = 170) with intermittent claudication were studied. The mean age was 65 years (33-89). Metabolic syndrome was diagnosed in 98 patients (57.6%). The mean age of patients with MetS was 63.5 years compared with 67.0 years for patients without MetS (P = .027). Considering patients aged ≥65 years, MetS was present in 46 (48.9%) individuals and in 52 (68.4%) patients younger than 65 years (P = .011). Metabolic syndrome must be actively searched for in claudicant patients.


Subject(s)
Intermittent Claudication/complications , Leg/blood supply , Metabolic Syndrome/complications , Adult , Aged , Aged, 80 and over , Female , Humans , Intermittent Claudication/pathology , Male , Metabolic Syndrome/diagnosis , Middle Aged , Peripheral Vascular Diseases/complications , Peripheral Vascular Diseases/pathology , Waist-Hip Ratio
15.
J. vasc. bras ; 6(3): 280-283, set. 2007. ilus
Article in English, Portuguese | LILACS | ID: lil-472918

ABSTRACT

A recanalização espontânea tardia da carótida interna é um evento incomum e pouco estudado. Os autores relatam o caso de paciente de 73 anos, masculino, hipertenso, com antecedente de acidente vascular cerebral há 3 anos, com seqüela motora e sensitiva em membro superior direito, apresentando ao mapeamento dúplex e arteriografia oclusão total da carótida interna. Evoluiu após 2 anos com novos episódios de ataques isquêmicos transitórios de repetição. Submetido a novos exames de imagem para avaliação da circulação cerebral extra e intracraniana, evidenciou-se recanalização do vaso, com estenose severa. Foi realizada endarterectomia de carótida esquerda, sem intercorrências. Paciente evoluiu sem novos episódios após 1 mês de seguimento. Considerando a raridade do caso e a parca literatura sobre recanalização tardia de carótida, passível de reparo cirúrgico, optamos pela apresentação do caso enfocando a importância do acompanhamento de oclusões carotídeas.


Late spontaneous recanalization of internal carotid artery is an unusual event that has received little attention. The authors report a case of a 73-year-old male patient, hypertensive, with previous history of cerebral vascular accident 3 years ago, with sensorimotor sequela in the right upper limb. Duplex scanning and arteriography showed total occlusion of the internal carotid artery. The patient progressed after 2 years with new episodes of recurrent transient ischemic attacks. When submitted to new imaging examinations to assess extra- and intracranial circulation, vessel recanalization was demonstrated, with severe stenosis. Left carotid endarterectomy was uneventfully performed. The patient progressed without new episodes after a 1-month follow-up. Considering the case rarity and the lack of literature on late carotid artery recanalization that can be surgically repaired, we decided to present this case focusing on the importance of following carotid artery occlusions.


Subject(s)
Humans , Male , Aged , Carotid Artery, Internal/surgery , Carotid Stenosis/surgery , Carotid Stenosis , Remission, Spontaneous , Stroke/complications , Stroke/diagnosis , Cerebral Angiography/methods , Cerebral Angiography
16.
J. vasc. bras ; 4(2): 149-154, jun. 2005.
Article in Portuguese | LILACS | ID: lil-466296

ABSTRACT

Objetivo: Análise de 20 casos quanto à casuística, etiologia, lesões associadas, tipos de tratamento e evolução das lesões traumáticas traumáticas da artéria subclávia, no período de janeiro de 1997 a dezembro de 2001. Métodos: Estudo retrospectivo por levantamento de prontuários no serviço de arquivo médico do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). Termos pesquisados: lesão de subclávia, pseudo-aneurisma de subclávia e fístula arteriovenosa de subclávia. Resultados: Foram analisados 77 prontuários, dos quais 20 se enquadravam em lesões desses ramos...


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Subclavian Artery/injuries , Wounds and Injuries/complications , Wounds and Injuries/mortality , Transplants , Angiography
17.
J. vasc. bras ; 3(4): 387-391, dez. 2004. ilus, tab
Article in Portuguese | LILACS | ID: lil-404914

ABSTRACT

Trata-se do relato de um caso de crescimento de aneurisma da aorta abdominal, após correção endovascular com sucesso, com exclusão de vazamento e baixa pressão no interior do saco aneurismático.Haverá a discussão dos possíveis fatores etiológicos envolvidos, bem como da abordagem terapêutica adotada no caso, com reduçãovolumétrica cirúrgica do saco aneurismático sem substituição da endoprótese.


Subject(s)
Humans , Male , Adult , Aortic Aneurysm, Abdominal/surgery , Aortic Aneurysm, Abdominal/complications , Hemorrhage/complications , Hemorrhage/diagnosis , Prostheses and Implants
18.
Acta oncol. bras ; 23(2): 432-440, abr.-jun. 2003. tab
Article in Portuguese | LILACS, Inca | ID: lil-430835

ABSTRACT

Introdução: Os dispositivos totalmente implantáveis vem sendo cada vez mais utilizados para quimioterapia de pacientes oncológicos porém poucos são os estudos em nosso meio que analisam os resultados obtidos com o implante e utilização desses cateteres. Material e Métodos: foram colocados 430 cateteres totalmente implantáveis em 415 pacientes a serem submetidos a regime de quimioterapia preferencialmente utilizando-se a veia jugular externa direita. Foram avaliadas as complicações precoces, as tardias e a evolução até a retidada do dispositivo, morte ou fim do tratamento. Resultados: a análise prospectiva mostrou uma duração média dos cateteres de 290 dias. Não se observou nenhuma complicação em 340 pacientes. Entre as complicações precoces observamos 11 hematomas de trajeto, 10 arritmias, 6 tromboflebites de coto distal de veia jugular externa e uma infecção de bolsa de subcutânea. Entre as complicações tardias, observamos 38 complicações infecciosas (0,3/1000 dias de uso de cateter), 10 obstruções (0,08/1000 dias de uso de cateter) e 13 tromboses venosas profundas (0,11/1000 dias de uso de cateter). Foram retirados 77 cateterers, 29 relacionados às complicações e 48 por final de tratamento. 172 pacientes foram a óbito com o cateter e 181 pacientes ainda o utilizavam para quimioterapia. Conclusão: as baixas taxas de complicação obtidas nesse estudo que implicaram em perda do cateter confirmam a segurança e conveniência do uso dos acessos totalmente implantáveis em pacientes em regime prolongado de quimioterapia.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Catheterization, Central Venous , Catheterization , Catheters, Indwelling , Neoplasms
19.
Reprod. clim ; 12(3): 130-3, 1997. tab
Article in Portuguese | LILACS | ID: lil-284394

ABSTRACT

O trabalho tem por objetivo avaliar o índice de insatisfaçäo pós-laqueadura tubária e propor meios para diminuir essa incidência. 310 pacientes do CAISM-ABC submetidas à laqueadura tubária entre os anos de 1971 e 1995, que foram entrevistadas e divididas em dois grupos: 1- Pacientes que fizeram parte do programa e realizaram a cirurgia em outros serviços. O índice de insatisfaçäo foi de 19,48 por cento tendo como causa principal o desejo de ter mais filhos. Os autores concluem que uma orientaçäo adequada a respeito do método é essencial para diminuir o índice de insatisfaçäo e propöem um programa de orientaçäo multidisciplinar.


Subject(s)
Humans , Female , Adult , Patient Satisfaction/statistics & numerical data , Sterilization, Tubal , Family Development Planning , Women's Health Services
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