A 6-year-old female child sought medical service due to a gastrointestinal malformation. During medical follow-up, partial absence of the inferior vena cava was diagnosed, a rare congenital alteration affecting the vascular drainage from the inferior segment of the body. Imaging exams were accomplished, contributing to evaluation and description of the case. Conservative treatment with oral anticoagulant was maintained. The patient presents good evolution after long-term cardiovascular follow-up.
ObjectiveTo compare the perioperative incidence rates of hemolysis and inflammatory
response in patients undergoing coronary artery bypass grafting with the two
main types of cardiopulmonary bypass, centrifugal and roller pumps, and
establish correlations among hemolytic and inflammatory changes.MethodsThis was a prospective, randomized trial of 60 patients assigned to either
roller pump (G1, n=30) or centrifugal pump (G2, n=30) bypass. Markers of
hemolysis (serum haptoglobin, lactate dehydrogenase [LDH]) and
inflammation (interleukin [IL]1ß, IL-6, and
TNF-α) were measured and analyzed.ResultsThere was no significant between-group difference in the variables of
interest. In G1, there was a positive association with IL-6 and TNF-α
(P<0.01 and P<0.05,
respectively). In G2, there was a positive association with LDH in the
postoperative period (P<0.5). At 24h
post-cardiopulmonary bypass, there were positive associations between LDH
and IL-1ß (P<0.05), LDH and TNF-α
(P<0.01), haptoglobin and TNF-α
(P<0.05), and LDH and TNF-α
(P<0.01) in G1, and between LDH and IL-6
(P<0.01), LDH and TNF-α
(P<0.01), and LDH and IL-6 (P<0.01)
in G2.ConclusionThere were no significant between-group differences in markers of hemolysis
or inflammation. IL-6 and TNF-α were positively associated with
duration of cardiopulmonary bypass in G1, while LDH was positively
associated with duration of cardiopulmonary bypass in G2. The rate of
significant associations between markers of hemolysis and inflammation was
higher in the roller pump group (G1).Registration numberReBEC (RBR-92b9dg).
Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass Abstract Objective: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass.Methods: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was evaluated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days.
Glomerular filtration rate (GFR) was calculated by
ResumoObjetivo: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina.
Heyde syndrome manifests as aortic stenosis associated with gastrointestinal
bleeding. We describe the case of a 64-year-old man who came to the emergency
room due to acute heart failure and intermittent gastrointestinal bleeding.
Treatment involves initial correction of anemia and heart failure followed by
aortic valve replacement. The prosthesis used depends on the characteristics of
each patient and valve replacement allows the resolution of bleeding in most
cases. Gastrointestinal bleeding in patients with aortic stenosis is associated
with severity of the valve obstruction. A mechanical prosthesis was used with no
recurrent bleeding even with the need for lifelong anticoagulation therapy.
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