OBJECTIVE To analyze the spatial distribution of homicide mortality in the state of
Bahia, Northeastern Brazil.METHODS Ecological study of the 15 to 39-year old male population in the state of
Bahia in the period 1996-2010. Data from the Mortality Information System,
relating to homicide (X85-Y09) and population estimates from the Brazilian
Institute of Geography and Statistics were used. The existence of spatial
correlation, the presence of clusters and critical areas of the event
studied were analyzed using Moran’s I Global and Local indices.RESULTS A non-random spatial pattern was observed in the distribution of rates, as
was the presence of three clusters, the first in the north health district,
the second in the eastern region, and the third cluster included townships
in the south and the far south of Bahia.CONCLUSIONS The homicide mortality in the three different critical areas requires
further studies that consider the socioeconomic, cultural and environmental
characteristics in order to guide specific preventive and interventionist
practices.
Nutcracker syndrome refers to signs and symptoms secondary to compression of the left renal vein, most commonly between the superior mesenteric artery and the aorta, leading to impaired outflow to the vena cava. Diagnosis of this syndrome is often difficult and as result is late in most cases. We report on the case of a 51-year-old woman successfully treated with embolization of the ovarian vein and insertion of a self expandable stent in the left renal vein. Technical details and pitfalls are discussed.Keywords: Nutcracker Syndrome; Nutcracker phenomenon; renal vein entrapment; Pelvic Congestion Syndrome.
ResumoA Síndrome do Quebra-nozes se refere a um conjunto de sinais secundários à compressão da veia renal esquerda, mais comumente entre a artéria mesentérica superior e a aorta, levando ao comprometimento do fluxo para a veia cava. O diagnóstico desta síndrome frequentemente é difícil e, por esta razão, o diagnóstico é demorado, em muitos casos. É relatado, nesta publicação, o caso de uma mulher de 51 anos, tratada com sucesso pela embolização da veia ovariana associada ao implante de stent autoexpansível na veia renal esquerda. São discutidos os aspectos técnicos e as dificuldades do procedimento. phlebography showed the superior mesenteric artery pressing down on the left renal vein and significant dilation of the ovarian vein (Figures 2 and 3). The short sheath was changed for an 8F long sheath and selective catheterization of ovarian vein was conducted preparatory to embolization with a Renegade® microcatheter and release four 12×30 mm Interlock® springs, followed by infusion of 5 ml of 3% polidocanol in a dense foam (Figure 4). A 16 mm×60 mm self-expanding Wallstent® was then implanted in the left renal vein and angioplasty conducted with a 12×40 mm XXL balloon, taking care to maintain an anchorage area both proximally and distally, to avoid migration to the cava ( Figure 5). Control phlebography showed that satisfactory correction of left renal vein compression and
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