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RESUMO: Paciente do sexo feminino, 59 anos, comerciante. Assintomática até há 1 ano, quando observou surgimento de massa pulsátil em dorso do pé direito, eventualmente dolorosa.
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RESUMO: Paciente do sexo feminino, 51 anos, com doença arterial coronariana (DAC), angina e dispnéia (classe III NYHA)...
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Oncologia , Neoplasias , Brasil , Diagnóstico por Imagem , Humanos , Neoplasias/diagnóstico por imagemAssuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Diagnóstico por Imagem/métodos , Ultrassonografia/métodos , Guias como Assunto/normas , Aorta Abdominal/diagnóstico por imagem , Artéria Renal/diagnóstico por imagem , Artéria Vertebral , Doenças Cardiovasculares/diagnóstico , Artérias Carótidas , Doenças das Artérias Carótidas/diagnóstico , Fístula Arteriovenosa , Estenose das Carótidas/diagnóstico , Aneurisma da Aorta Abdominal/diagnóstico , Ultrassonografia Doppler Transcraniana/métodos , Trombose Venosa/diagnóstico , Doença Arterial Periférica/diagnóstico , Artéria Ilíaca/diagnóstico por imagem , Artérias Mesentéricas/diagnóstico por imagemRESUMO
Posicionamento de Ultrassonografia Vascular do Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia 2019. (AU)
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Humanos , Diagnóstico por Imagem , UltrassonografiaRESUMO
PURPOSE: To report novel optical coherence tomography findings in a case of anti-α-enolase cancer associated retinopathy. OBSERVATIONS: An elderly female presented with bilateral decreased vision and a recent diagnosis of ovarian carcinoma. Optical coherence tomography demonstrated bilateral loss of outer retinal structures and macular edema. Serum testing found antibodies against α-enolase and 82-84 kDa proteins. Outer retinal structures showed recovery, macular edema resolved and repeat anti-retinal antibody testing became negative following cancer therapy and topical difluprednate treatment. CONCLUSIONS AND IMPORTANCE: Cancer associated retinopathy is a paraneoplastic disease that results in damage to retinal structures through an autoimmune response. The damage is generally considered to be irreversible; however, in rare cases, such as observed here, retinal structures may demonstrate recovery after treatment.
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BACKGROUND: Several studies have demonstrated the benefits of replacing trans and saturated fats with unsaturated fatty acids on cardiovascular diseases. We aimed to demonstrate the effect of polyunsaturated and monounsaturated fat supplementation on the biochemical and endothelial markers of atherosclerotic disease in obese or overweight non-diabetic elderly patients. METHOD: Seventy-nine patients were randomly divided into three groups: flaxseed oil, olive oil, and sunflower oil; patients in each group received 30 mL of oil for 90 days. Patients were subjected to anthropometric and bioimpedance assessments; biochemical and endothelial evaluations were performed through ultrasonography of the brachial artery and carotid artery for endothelium-dependent dilation and intima-media thickness assessment, respectively, before and after the intervention. The participants' usual diet remained unchanged. RESULTS: The flaxseed oil group had improved ultra-sensitive C-reactive protein levels (p = 0.074) and reduced carotid intima-media thickness (CIMT) (p = 0.028); the olive oil group exhibited an improved apolipoprotein (Apo)B/ApoA ratio (p = 0.021), reduced CIMT (p = 0.028), and improved flow-mediated vasodilation (FMV) (p = 0.054); and similarly, the sunflower oil group showed an improved ApoB/ApoA ratio (p = 0.024), reduced CIMT (p = 0.048), and improved FMV (p = 0.001). CONCLUSION: Unsaturated fatty acid supplementation using the three vegetable oils attenuated pro-inflammatory properties and improved prothrombotic conditions. Therefore, introducing or replacing saturated and trans fat with unsaturated fatty acids is beneficial for cardiovascular risk reduction in obese or overweight non-diabetic elderly people. Further studies are needed to determine which unsaturated fat best prevents cardiovascular disease in elderly patients.
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Aterosclerose/dietoterapia , Biomarcadores/sangue , Doenças Cardiovasculares/prevenção & controle , Gorduras Insaturadas na Dieta/uso terapêutico , Ácidos Graxos Insaturados/uso terapêutico , Obesidade/dietoterapia , Sobrepeso/dietoterapia , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/complicações , Espessura Intima-Media Carotídea , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/fisiopatologia , Sobrepeso/sangue , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Óleos de Plantas/administração & dosagem , Fatores de RiscoRESUMO
Cardiovascular diseases are the leading cause of mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal women in Framingham Risk Score (FRS) low and intermediate groups. Computed tomography (CT) and ultrasound (US) scans were performed in 138 asymptomatic postmenopausal women (56.1 ± 4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assess carotid intima-media thickness (CIMT) and identify carotid plaques (US). The mean FRS was 2.64 ± 2.13 %. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC) >0 and aortic calcification (AC) were, respectively, 45.7, 37.7, 62.3, 23.9 and 45.7 %. Normal imaging tests were found in 22.4 %. SA, defined as at least one abnormal imaging test, was associated with age, FRS, waist-to-rip ratio, systolic and diastolic blood pressure, HDL-c and ApoA1 levels, and ApoA1/ApoB ratio. In logistic regression, SA was associated with higher age (OR 1.108, 95 % CI 1.010-1.215, p = 0.029) and lower ApoA1 levels (OR 0.979, 95 % CI 0.960-0.998, p = 0.029). SA was prevalent in Brazilian postmenopausal women with low and intermediate risk groups (FRS) and was associated with higher age and lower levels of ApoA1. Carotid atherosclerosis was the most common presentation of SA in this group.
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Doenças da Aorta/epidemiologia , Aterosclerose/epidemiologia , Doenças das Artérias Carótidas/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Pós-Menopausa , Calcificação Vascular/epidemiologia , Adulto , Idoso , Doenças da Aorta/sangue , Doenças da Aorta/diagnóstico por imagem , Aortografia/métodos , Doenças Assintomáticas , Aterosclerose/sangue , Aterosclerose/diagnóstico por imagem , Biomarcadores/sangue , Pressão Sanguínea , Brasil/epidemiologia , Doenças das Artérias Carótidas/sangue , Doenças das Artérias Carótidas/diagnóstico por imagem , Espessura Intima-Media Carotídea , Distribuição de Qui-Quadrado , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Lipídeos/sangue , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Placa Aterosclerótica , Pós-Menopausa/sangue , Prevalência , Medição de Risco , Fatores de Risco , Calcificação Vascular/sangue , Calcificação Vascular/diagnóstico por imagem , Relação Cintura-QuadrilRESUMO
Cardiovascular diseases are the leading causeof mortality among women in several countries. Early detection of subclinical atherosclerosis (SA) could enable the adoption of preventive measures to avoid cardiovascular events. This study aimed to determine the prevalence of SA in Brazilian asymptomatic postmenopausal womenin Framingham Risk Score (FRS) low and intermediategroups. Computed tomography (CT) and ultrasound (US)scans were performed in 138 asymptomatic postmenopausal women (56.1±4.9 years of age) to survey for coronary artery and aortic calcification (CT scan) and assesscarotid intima-media thickness (CIMT) and identify carotidplaques (US). The mean FRS was 2.64±2.13%. The prevalence of increased CIMT, carotid plaques, increased CIMT and/or plaques, coronary artery calcification (CAC)>0 and aortic calcification (AC) were, respectively, 45.7,37.7, 62.3, 23.9 and 45.7%. Normal imaging tests werefound in 22.4%. SA, defined as at least one abnormalimaging test, was associated with age, FRS, waist-to-ripratio, systolic and diastolic blood pressure, HDL-c andApoA1 levels, and ApoA1/ApoB ratio...
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Aterosclerose , Doenças Cardiovasculares , Medição de Risco , MenopausaRESUMO
BACKGROUND: Several studies have demonstrated the benefits of replacing trans and saturated fats with unsaturated fatty acids on cardiovascular diseases. We aimed to demonstrate the effect of polyunsaturated and monounsaturated fat supplementation on the biochemical and endothelial markers of atherosclerotic disease in obese or overweight non-diabetic elderly patients. METHOD: Seventy-nine patients were randomly divided into three groups: flaxseed oil, olive oil, and sunflower oil; patients in each group received 30 mL of oil for 90 days. Patients were subjected to anthropometric and bioimpedance assessments; biochemical and endothelial evaluations were performed through ultrasonography of the brachial artery and carotid artery for endothelium-dependent dilation and intima-media thickness assessment, respectively, before and after the intervention. The participants' usual diet remained unchanged...
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Aterosclerose , Endotélio Vascular , Espessura Intima-Media Carotídea , Idoso , Inflamação , Obesidade , Rigidez Vascular , Ácidos Graxos InsaturadosRESUMO
Stenting for CoA has become an acceptable treatment modality in the last 20 years. However little is known about arterial changes after this procedure. To assess arterial structure and function including peripheral reactivity and stiffness and intima-media thickness (IMT) pre and post stenting for coarctation of the aorta (CoA). Twenty-one patients [median age: 15 years (8-39)] were studied at baseline, 1 day, 6 months and 1 year after stenting. Twenty-one healthy subjects (1:1 matched) were used as controls. Left ventricular (LV) mass, ejection fraction, flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD) of left brachial artery, common carotid (CC) and right subclavian artery (RSCA) IMT and pulse wave velocity (PWV) were assessed by echocardiography and vascular ultrasound. CoA patients had higher LV indexed mass (p < 0.0001), impaired FMD (p < 0.0001) and NMD (p < 0.0001), increased PWV (p < 0.0001), carotid and RSCA IMT (both p < 0.0001). All procedures were successful and resulted in significant gradient reduction (p < 0.001). One year after stenting there was improvement in LV function (p = 0.034) and although there was significant reduction of LV mass (103.29 ± 24.77 vs. 74.39 ± 22.07 g/m(2), p < 0.0001) values did not normalize. There was no significant change in FMD, NMD, PWV and CC or RSCA IMT. In patients with CoA, arterial reactivity is impaired and LV mass, arterial stiffness and thickness are increased. Although stenting is successful to relieve the obstruction resulting in better LV function and mass reduction, arterial structure and function remains abnormal after 1 year of follow-up.