RESUMEN
Objetivos: La psoriasis se asocia a la disfunción endotelial, lo cual provoca un deterioro del funcionamiento vascular. Los inhibidores del TNF-alpha han mostrado la capacidad de mejorar el funcionamiento vascular en la psoriasis. El índice de resistencia de los vasos ungueales (IRVU) evalúa el funcionamiento microvascular en la uña. El objetivo del estudio fue evaluar el efecto de la inhibición del TNF-alpha con adalimumab en el IRVU. Material y métodos: Estudio cuasiexperimental. Quince pacientes con psoriasis moderada-grave recibieron adalimumab 40mg sc según ficha técnica. Se valoró a los participantes al inicio y a las 12, 24 y 52 semanas tras la intervención del estudio. Resultados: En la semana 52 se observó una reducción del IRVU de −0,09±0,02 (p<0,01) y de −11,2±2,41ng/ml (p<0,001) en la E-selectina. Conclusiones: Adalimumab podría producir una reducción progresiva y sostenida de la resistencia de los vasos ungueales y marcadores de disfunción endotelial
Objectives: Psoriasis is associated to endothelial dysfunction, which causes impaired vascular functioning. TNF-alpha blockers have shown the ability to improve vascular functioning in psoriasis. The nailfold vessel resistance index (NVRI) assesses microvascular functioning at nailfold. The objectives of the study is to assess the effect of the TNF-alpha inhibition with adalimumab on NVRI. Material and methods: Quasi-experimental study. Fifteen patients with moderate-severe psoriasis received adalimumab 40mg sc according to label information. Participants were assessed at baseline and at 12, 24 and 52 weeks after study intervention. Results: A reduction of −0.09±0.02 (P<.01) in NVRI and a −11.2±2,41ng/ml (P<.001) in E-selectin was observed at week 52. Conclusions: Adalimumab could produce a progressive and sustained reduction of vessel resistance at nailfold and E-selectin in patients with psoriasis
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Psoriasis/fisiopatología , Endotelio Vascular/fisiopatología , Adalimumab , Ultrasonografía Doppler/métodos , Ensayos Clínicos Controlados no Aleatorios como Asunto/métodos , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Microvasos/fisiología , Uñas/irrigación sanguínea , Biomarcadores , Resistencia Vascular , Selectina ERESUMEN
OBJECTIVES: Psoriasis is associated to endothelial dysfunction, which causes impaired vascular functioning. TNF-α blockers have shown the ability to improve vascular functioning in psoriasis. The nailfold vessel resistance index (NVRI) assesses microvascular functioning at nailfold. The objectives of the study is to assess the effect of the TNF-α inhibition with adalimumab on NVRI. MATERIAL AND METHODS: Quasi-experimental study. Fifteen patients with moderate-severe psoriasis received adalimumab 40mg sc according to label information. Participants were assessed at baseline and at 12, 24 and 52 weeks after study intervention. RESULTS: A reduction of -0.09±0.02 (P<.01) in NVRI and a -11.2±2,41ng/ml (P<.001) in E-selectin was observed at week 52. CONCLUSIONS: Adalimumab could produce a progressive and sustained reduction of vessel resistance at nailfold and E-selectin in patients with psoriasis.
Asunto(s)
Adalimumab/uso terapéutico , Antirreumáticos/uso terapéutico , Proteína C-Reactiva/análisis , Selectina E/sangre , Endotelio Vascular/fisiopatología , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Ultrasonografía Doppler , Resistencia Vascular/efectos de los fármacos , Adalimumab/farmacología , Adulto , Antirreumáticos/farmacología , Biomarcadores , Endotelio Vascular/diagnóstico por imagen , Humanos , Microcirculación/efectos de los fármacos , Persona de Mediana Edad , Uñas/irrigación sanguínea , Estudios Prospectivos , Psoriasis/sangre , Psoriasis/fisiopatología , Índice de Severidad de la EnfermedadRESUMEN
Fundamento y objetivo: Se pretende estudiar la asociación del glaucoma con la enfermedad vascular, mediante 2 vías independientes: la asociación del glaucoma con las enfermedades cardiovasculares (ECV) y el estudio de las variables de hemodinámica ocular (VHO) en el glaucoma. Material y método: Se realizó un estudio transversal con 73 sujetos: 25 sin glaucoma, 28 glaucomas primarios de ángulo abierto (GPAA) y 20 glaucomas de tensión normal (GTN). Se midieron las VHO, factores de riesgo cardiovascular (FRCV) y ECV. Resultados: Se encontró un mayor porcentaje de FRCV y ECV en pacientes afectados de GPAA (p = 0,002 y p = 0,016) y GTN (p = 0,001 y p = 0,010) respecto al grupo control. En lo que respecta a las VHO, en los pacientes con GPAA encontramos menores velocidades sistólicas y diastólicas, así como mayores índices de resistencia en la arteria central de la retina (p < 0,05). Además, en ambos tipos de glaucoma encontramos índices de resistencia más elevados en la arteria ciliar posterior (p < 0,05). Conclusiones: Existe una asociación estadísticamente significativa entre la presencia de ECV y/o FRCV y la enfermedad glaucomatosa, hallazgo que se complementa con los datos de las VHO. Estos valores indican una peor perfusión ocular en los pacientes con enfermedad glaucomatosa (AU)
Background and objective: We sought to study the association of glaucoma with vascular disease, with 2 independent pathways: the association of glaucoma with cardiovascular disease (CVD) and the study of ocular hemodynamic variables (OHV) in glaucoma. Material and method: Cross-sectional study consisting of 73 patients: 25 without glaucoma, 28 primary open-angle glaucoma (POAG) and 20 normal-tension glaucoma (NTG). OHV, cardiovascular risk factors (CVRF) and CVD were determined. Results: We found a greater number of CVRF and CVD in patients affected by POAG (P = .002 and P = .016) and NTG (P = .001 and P = .010) compared to the control group. With regard to OHV, in patients suffering from POAG, we found lower systolic and diastolic velocities and higher resistance index in the central retinal artery (P < .05). Moreover, in both types of glaucoma, we found higher resistance index in the posterior ciliary artery (P < .05). Conclusions: There is a statistically significant association between the presence of CVD and/or CVRF and glaucomatous disease, a finding that is supplemented with data from the OHV. These values indicate a worst ocular perfusion in patients with glaucomatous disease (AU)
Asunto(s)
Humanos , Glaucoma/fisiopatología , Enfermedades Cardiovasculares/epidemiología , Hemodinámica , Glaucoma/complicaciones , Factores de Riesgo , Fenómenos Fisiológicos Oculares , Estudios Transversales , Estudios de Casos y Controles , Hipertensión Ocular/complicaciones , Hipertensión/complicacionesRESUMEN
BACKGROUND AND OBJECTIVE: We sought to study the association of glaucoma with vascular disease, with 2 independent pathways: the association of glaucoma with cardiovascular disease (CVD) and the study of ocular hemodynamic variables (OHV) in glaucoma. MATERIAL AND METHOD: Cross-sectional study consisting of 73 patients: 25 without glaucoma, 28 primary open-angle glaucoma (POAG) and 20 normal-tension glaucoma (NTG). OHV, cardiovascular risk factors (CVRF) and CVD were determined. RESULTS: We found a greater number of CVRF and CVD in patients affected by POAG (P=.002 and P=.016) and NTG (P=.001 and P=.010) compared to the control group. With regard to OHV, in patients suffering from POAG, we found lower systolic and diastolic velocities and higher resistance index in the central retinal artery (P<.05). Moreover, in both types of glaucoma, we found higher resistance index in the posterior ciliary artery (P<.05). CONCLUSIONS: There is a statistically significant association between the presence of CVD and/or CVRF and glaucomatous disease, a finding that is supplemented with data from the OHV. These values indicate a worst ocular perfusion in patients with glaucomatous disease.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Glaucoma/fisiopatología , Hemodinámica , Adulto , Anciano , Enfermedades Cardiovasculares/fisiopatología , Estudios Transversales , Ecocardiografía Doppler en Color , Femenino , Glaucoma/epidemiología , Glaucoma de Ángulo Abierto/epidemiología , Glaucoma de Ángulo Abierto/fisiopatología , Humanos , Hipertensión/epidemiología , Glaucoma de Baja Tensión/epidemiología , Glaucoma de Baja Tensión/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Riesgo , España/epidemiología , Campos VisualesRESUMEN
The purpose of this study was to determine the incidence of arterial false aneurysms following hip surgery diagnosed and treated in our hospital between January 1995 and January 2010. We conducted a retrospective analysis of all patients undergoing hip surgery (osteosynthesis, hemiarthroplasty, total arthroplasty, or revision arthroplasty) under our care. To determine the incidence of arterial false aneurysm, we identified patients with abnormal bleeding through the surgical wound postoperatively. Out of the 11,839 patients undergoing hip surgery during the study period, 321 had abnormal bleeding that aroused suspicion of an associated vascular lesion. Among these, the presence of a false aneurysm requiring specific treatment was confirmed in eight patients. False aneurysms are a rare and occasionally severe complication of hip surgery that typically manifest with significant haemorrhage during the postoperative period. The management of these lesions by interventional radiology is associated with few complications and permits rapid patient stabilisation and early recovery, avoiding more aggressive and sometimes fruitless surgical exploration.