Impact of screening on thrombophilia for patients with venous thrombosis.

AIM: The epidemiologic importance of thrombophilia on venous thromboembolism (VTE) has been extensively studied. We tried to identify the variables that point to the positive test results for thrombophilia and the impact of these results on clinical decisions. METHODS: Thrombophilia screening was applied to 84 consecutive patients with VTE. After test results, two independent observers evaluated, in a case by case basis, the indication of a change on prophylaxis or special attention, in order to modify the period of anticoagulant intake or have a higher medical surveillance before risk situations or for the extension of the research to the first degree relatives. RESULTS: Thrombophilia was found in 41.66% (35/84), and in 32.12% (27/84) it involved a genetic cause. The factor V Leiden was found in 15.47%, followed by the natural anticoagulant dysfunction (11.9%). There was no significative difference of thrombophilia frequency between ages, nor a difference of age in the onset of the first thrombotic event between thrombophilic and non-thrombophilic patients. There was a higher prevalence of thrombophilia in patients with superficial thrombophlebitis of spontaneous onset and in cases of recurrence. The change on prophylaxis resulted in 7.14% (6/84) and special attention in 40.47% (34/84). CONCLUSIONS: Spontaneous superficial thrombophlebitis, occurrence of VTE related to non surgical causes, and recurrence, were the main findings which suggested thrombophilia. The change of prophylaxis was applied to a small percentage of patients. The special attention for risk situations and the extension of the primary prophylaxis to the asymptomatic family members seems to be the best indication for the laboratory research on thrombophilia.

Aplicacao da fotopletismografia no estudo da hipertensao venosa dos membros inferiores. / Use of photopletysmography in the study of lower limbs venous insufficiency

Fotopletismografia (P.P.G) foi utilizada na avaliacao do tempo de reenchimento venoso em 20 pacientes con sequela de trombose nervosa profunda unilateral. O membro assintomatico foi utilizado como controle.Na estremidade normal, o tempo medico de reenchimento foi de 365 comparado com 16,5 s e simples, nao-invasivo, pouco dispendioso e pode ser muito util na avaliacao de pacientes com edema de extremidade inferior de etiologia desconhecida

Avaliacao do arco palmar pelo exame ultra-sonico de Doppler. / Evaluation of the palmar arch by Doppler ultrasound examination

Os autores demonstram que o uso do Doppler via avaliacao da integridade do arco palmar e de fundamental importancia antes de se realizar qualquer procedimento em arterias de punho. Alem disso, este exame e de maior confiabilidade do que a manobra de Allen, pela sua grande sensibilidade diagnostica

Revascularizacao cerebral em obstrucoes de arteria carotida interna e seus ramos. / Cerebral revascularization in obstruction of the internal carotid arteries and their branches

Os autores tentaram demonstrar que lesoes de arteria carotida denominadas inacessiveis, ja nao sao assim consideradas, visto que pela microcirurgia sao corrigidas. A vascularizacao cerebral e feita pela anastomose da arteria temporal superficial com ramos corticais temporais da arteria cerebral