RESUMO
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Assuntos
Humanos , Masculino , Feminino , Dor/tratamento farmacológico , Cuidados Paliativos/métodos , Neoplasias/tratamento farmacológico , Analgésicos Opioides/uso terapêutico , Eficácia/métodos , Resultado do Tratamento , Analgésicos/uso terapêutico , Analgésicos/antagonistas & inibidores , Analgésicos/síntese químicaRESUMO
OBJECTIVE: Macrovascular disease in scleroderma has recently been described in two comparative studies. The aim of this study was to map its anatomical distribution. METHODS: In a retrospective cohort study of 20 scleroderma patients, the results of Doppler studies of arteries in the limbs, neck, and abdomen were compared with those from 20 cohort negative patients. The latter were matched for age, sex, and the presence/absence of hypertension, hyperlipidaemia, smoking, and diabetes status. Arteries were compared quantitatively using a body surface area adjusted measurement of intraluminal diameter, and qualitatively using descriptive characteristics of the arterial walls. The latter were binomially categorised under three non-exclusive headings--thickening, stenosis, and calcification. RESULTS: The ulnar arteries in scleroderma patients were significantly narrower than those of the negative cohort. The arterial walls were also characterised by smooth thickening along their entire length. The characteristics of the other arteries, including those of the lower limbs, were not significantly different from those of the negative cohort. CONCLUSION: The ulnar artery seems to be specifically targeted in patients with scleroderma. Assessment of the ulnar artery should be considered in these patients by means of a modified Allen's test or Doppler sonography especially in the presence of digital gangrene.
Assuntos
Doenças Vasculares Periféricas/etiologia , Escleroderma Sistêmico/complicações , Idoso , Amputação Cirúrgica , Anticorpos Anticardiolipina/sangue , Arteriopatias Oclusivas/etiologia , Arteriopatias Oclusivas/patologia , Estudos de Coortes , Feminino , Humanos , Perna (Membro)/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Escleroderma Sistêmico/imunologia , Artéria Ulnar/patologiaRESUMO
The case of a 68 year old woman with a sudden onset of visual loss in the left eye is reported. Carotid duplex scanning revealed a 50-75% stenosis of the left internal carotid artery, with a floating tail of clot extending into the lumen of the artery. Emergency carotid endarterectomy, removing the plaque with the attached thrombus, was performed.
