BackgroundCardiovascular diseases are the major cause of morbidity and mortality in
developed and emerging countries. Their main etiology, atherosclerosis, is a
disseminated disease that affects the coronary, cerebral and peripheral
territories. The peripheral arterial disease (PAD), as well as its consequences,
indicates the involvement of the coronary territory. Therefore, its better
understanding enables proper treatment, delaying local and long-term
complications, reducing the cost to the health system. Objective This study estimates the percentage of PAD in Japanese-Brazilians from Bauru
(SP), recognized by the high prevalence of metabolic disorders such as
hypertension (43%), diabetes mellitus (33%) and hypercholesterolemia (60%), and
examines the association with risk biomarkers. MethodsThis cross-sectional population study evaluated 1,330 Japanese-Brazilians of both
genders aged ≥ 30 who underwent a complete physical examination,
anthropometric measurements, laboratory tests and ankle-brachial index (ABI).
Participants with ABI ≤ 0.90 were diagnosed as having PAD. After applying
the exclusion criteria, 1,038 individuals were part of the analysis. We used
Poisson regression to analyze associations with PAD. Results The mean age was 56.8 years and the percentage of PAD was 21.1%, equal among the
genders. PAD was associated with smoking (PR 2.16 [1.33 to 3.48])
and hypertension (PR 1.56 [1.12-2.22]). ConclusionThe percentage of PAD in Japanese-Brazilians was similar to other populations of
adverse cardiometabolic profile (US PARTNERS and POPADAD). The independent
association of PAD with smoking and hypertension, but not with other classical
risk factors, may depend on the very high frequencies of metabolic disorders in
this population.
We describe an unusual case of a post-traumatic fat embolism in the vena cava and left femoral vein identified on CT before the onset of fat embolism syndrome. The patient was successfully treated by insertion of a vena cava filter and venous thrombectomy. This is the first occurrence of early identification of a large fat embolus allowing its extraction before occurrence of severe respiratory failure.
Background: Chronic venous disease demands clinical assessment, quantification of hemodynamic effects, and definition of anatomic distribution before diagnostic and treatment decisions can be made. Methods: This is a prospective study conducted in 2015 with a sample of 1,384 patients (2,669 limbs) aged from 17 to 85 years, 1,227 of whom were female. The most common symptoms reported in response to the questionnaire were pain, tiredness, feelings of heaviness, burning, cramps, and tingling. Subsets were formed on the basis of number of limbs distributed by sex, body mass index, and age. After definition of subsets, Doppler ultrasonography was used to conduct examinations of the great saphenous vein (GSV) and patients were distributed into three clinical groups (I: symptoms present and varicose veins absent, II: symptoms absent and varicose veins present and III: symptoms present and varicose veins present). Statistical analysis employed the chi-square test or Fisher' s exact test to test for homogeneity between groups. When associations significant to 5% were detected, odds ratios were calculated. Results: For both sexes, the chance of GSV insufficiency was 11.2 times greater in group III. Among cases with morbid obesity, the chance was 9.1 times greater in the same group. Additionally, patients in this group with ages ranging from 30 to 50 years exhibited a 43.1 times greater chance of GSV insufficiency. Conclusions: Insufficiency of the GSV was significantly more frequent in group III, both overall and when considering only cases with morbid obesity, or cases in older age groups.
conception, design, intellectual and scientific content of the study.
ABSTRACT PURPOSE:To investigate the neovascularization after exposure of the external jugular venous endothelium in an experimental model.
METHODS:
RESULTS:Neovascularization occurred with level of significance when compared group 1 to group 3 at 30 days (p=0.0076) and the same occurred at 60 days (p=0.0001) (Newman-Keuls test).
CONCLUSION:The group with exposure of the venous endothelium showed a significant increase of neovascularization when compared with other groups.
Background: Atherosclerosis is a multifactorial disease with an inflammatory pathophysiological basis. Cytokines released during the atherosclerotic process induce production of C-reactive protein (CRP) in the liver, which is an important marker of inflammation. Objective: We tested whether inflammatory biomarkers were associated with deterioration of peripheral arterial occlusive disease (PAOD) in a population at high cardiovascular risk. Methods: 1,330 subjects ≥30 years of age underwent clinical and laboratory examinations as part of a population-based study of the prevalence of diabetes. PAOD was defined as an ankle-brachial index (ABI) ≤0.90. After application of exclusion criteria, the sample comprised 1,038 subjects. Traditional risk factors, CRP and interleukin 6 (IL-6) were also compared across three ABI categories (≤0.70; 0.71-0.90; ≥0.90). Mean values for these variables were compared by presence/absence of DAOP (Student' s t test) and by ABI categories (ANOVA). Poisson regression and logistic regression models were used to test for associations between risk factors and DAOP and between risk factors and the ABI categories. Pearson' s linear correlation coefficients were calculated for the relationship between CRP and IL-6 levels. Results: Mean age was 56.8±12.9 years, 54% of the sample were women and the prevalence of DAOP was 21.0% (95%CI 18.4-24.1). Individuals with ABI ≤0.70 had higher concentrations of CRP-us (2.1 vs. 1.8) and of IL-6 (1.25 vs. 1.17). Concentrations of CRP and IL-6 were only correlated in patients with DAOP, (p=0.004). Conclusions: The finding that CRP and IL-6 levels were only elevated among people with advanced DAOP may suggest that these biomarkers have a role to play as indicators of more severe disease. Prospective studies are needed to test this hypothesis.
The association between low levels of ankle-brachial index and elevated levels of ultrasensitive C-reactive protein may suggest a relationship of gravity, aiding in the mapping of high-risk patients.
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