RESUMO
BACKGROUND: Infrarenal aortic diameter (AD) values currently considered normal are based on measurements from epidemiologic studies performed over 20 years ago. Knowledge of expected normal AD is important for understanding the relevance of abdominal aortic dilatation. The aim of this study was to define contemporary reference values for normal infrarenal AD and build a predictive model based on individual features. METHODS: A cross-sectional study of participants in a population-based screening program for abdominal aortic aneurysm (AAA) was performed in a healthcare district with 400,000 inhabitants. Men and women aged 65 years were invited to participate. Cardiovascular (CV) risk factors, family history of AAA, personal history of other aneurysms, CV disease, and anthropometric parameters were evaluated. The largest anteroposterior inner-inner diameter of the infrarenal aorta was measured by ultrasound. Multiple linear regressions were used to determine independent predictors of AD. The best-fit model was obtained by randomly selecting 70% of the sample and validating the results in the remaining 30%. RESULTS: A total of 4,730 people (2,089 men and 2,641 women) were invited. The participation rate was 50.4% for men and 44.0% for women. Mean AD (standard deviation, SD) was 16.51 (3.2) mm in the overall group, 17.91 (3.51) mm in men, and 15.25 (2.32) mm in women (P < 0.001). Male sex (P < 0.001), body surface area (P < 0.001), smoking habit (P = 0.012), and history of arterial aneurysms (P = 0.013) were independently associated with increased AD. Dyslipidemia was associated with decreased AD (P < 0.001). The findings were used to build a model for predicting AD based on individual characteristics. CONCLUSIONS: ADs in our study population are smaller than those described in classic epidemiological studies. Men have a significantly larger diameter than women and the strongest predictor of increased AD is body surface area. A greater understanding of factors associated with AD will help predict expected sizes in individual members of the population.
Assuntos
Aorta Abdominal , Aneurisma da Aorta Abdominal , Humanos , Masculino , Feminino , Fatores de Risco , Estudos Transversais , Resultado do Tratamento , Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/epidemiologia , Ultrassonografia , PrevalênciaRESUMO
El término enfermedad tromboembólica venosa se refiere a varios procesos patológicos, entre los que destacan la trombosis venosa profunda, el tromboembolismo pulmonar, la hipertensión pulmonar tromboembólica crónica y el síndrome postrombótico. La importancia en nuestro medio reside en que es una patología que precisa un periodo de recuperación largo, de 3 a 6 meses, y que un diagnóstico tardío o no bien realizado puede ocasionar una enfermedad más grave e incluso un desenlace fatal. Es difícil establecer su prevalencia en el ámbito del deporte, aunque de forma empírica parece ser similar a la del individuo que no hace deporte. Sin embargo, el ámbito del deporte y su entorno ofrece condiciones clínicas de riesgo que pueden ser factores que precipiten su presencia, la contusión sobre el lecho vascular, el reposo de los viajes, la deshidratación, la masoterapia mal orientada, ciertas medicaciones o una predisposición genética. La presente guía ofrece una actualización del proceso, se expone la protocolización diagnóstica, las pautas de prevención y de tratamiento estándar y aplicado al deporte, pensando no solo en el deportista sino también en el profesional y en el personal acompañante
The term venous thromboembolism refers to various pathological processes that include deep vein thrombosis, pulmonary embolism, chronic thromboembolic pulmonary hypertension and the thrombotic syndrome. The importance in sports activities is that it is a pathology that requires a long recovery period varying from 3 to 6 months, and a delayed or unsuccessful diagnosis can lead to a more serious illness and even death. Its prevalence in the field of sport is difficult to establish, but empirically seems to be similar to that of the individual who does not practice sport. However, the field of sport and its environment has other clinical risk conditions to be taken into account. Bruising on the vascular bed, rest, travel, dehydration, misguided massage therapy, certain medications, or a genetic predisposition, may be factors that precipitate their presence. This guide presents an update of the process, as well as the diagnostic protocol, with prevention guidelines and standard treatments and their application in sports, and takes into account not only the sportsman, but also in the professional and accompanying personnel
Assuntos
Humanos , Esportes , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/tratamento farmacológico , Heparina/uso terapêutico , AnticoagulantesRESUMO
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Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/educação , Cirurgia Geral/educação , Medicina Interna/educação , Internato e Residência , Doenças Vasculares , VeiasRESUMO
La agenesia infrarrenal de la vena cava inferior (VCI) es una malformación rara, con pocas publicaciones al respecto a nivel mundial. Es secundaria a una trombosis del segmento caudal de la vena supracardinal derecha en la fase embrionaria, debido en aproximadamente 60% de los casos según nuestra experiencia a un defecto genético de las proteínas C y/o S. La mayoría de los pacientes con esta patología observados son varones que debutan con clínica de trombosis venosa ílio-femoral. Presentamos un caso de agenesia de VCI infrarrenal en un joven de 22 años remitido desde medicina Interna (donde estaba en estudio desde hace más de 1 año por molestias abdominales y sudoración nocturna, así como febrícula ocasional)) con clínica de trombosis venosa profunda en extremidad inferior derecha. Se diagnosticó por eco-Doppler de trombosis venosa iliio-femora derecha y se practicó TC abdominal que objetivó agenesia de VCI infrarenal y trombosis veneosa ílio-femoral derecha. El estudio biológico de la enfermedad tromboembólica venosa (ETEV) evidenció un trastorno congénito de las proteínas C y S (AU)
The inferior vena cava agenesis is uncommon, with very few publications all over the world. Is secondary to thrombosis of caudal segment of right supracardinal vein in the embrionary development, as a result of genetic disturbances of C and/or S proteins in 60% of cases (in our experience). The majority of these patients are young men and initiate their symptomatology with signs of iliofemora thrombosis. We are presenting a patient of 22 years old with agenesia of inferior vena cava, remitted us by his internist (who examined him for abdominal discomfort, night sweat and fever occasionally) with symptoms of deep vein thrombosis of the right lower limb. The diagnosis was based in Doppler ecography study and CT images who showed the agenesia of infrarenal vena cava and iliofemora thrombosis. The biological study revealed congenital deficiencies of C and S proteins (AU)
Assuntos
Humanos , Masculino , Adulto Jovem , Malformações Vasculares/diagnóstico , Trombose Venosa/diagnóstico , Veia Femoral/fisiopatologia , Veias Cavas/anormalidades , Veia Femoral/anormalidades , Proteína C/genética , Proteína S/genéticaRESUMO
Se trata de un caso excepcional de thrombosis que afectó todo el sistema venosos profundo de la extremidad y la vena cava inferior. Clínicamente se presentó como una flegmasía cerúlea dolens, manifestación grave de la enfermedad tromboembólica venosa (ETEV). Para l a valoración diagnóstica se realizó tomografía computerizada observándose trombosis de la vena cava inferior hasta su nivel hepático. El tratamiento fue contundente con fibirnolíticos y heparina de bajo peso molecular, presentando una buena evolución y ninguna complicación (AU)
This is an exceptional case of thrombosis that affected all extremity Deep venous system and inferior digging. Clinically appeared like a serious manifestation of the venous thrombosis-embolism disease (ETEV). For diagnosis evaluation was made a tomography being observed vein inferior digs until its liver level. Treatment was forceful with fibrionolitics and low molecular weight heparine, displaying a good evolution and no complication (AU)
