Search

Objective: To analyse the efficacy of the procedure for withdrawing an inferior vena cava (IVC) filter and the clinical and radiological factors associated with difficult withdrawal., Material and Methods: This retrospective observational study included patients who underwent IVC filter withdrawal at a single centre between May 2015 and May 2021. We recorded demographic, clinical, procedural, and radiological variables: type of IVC filter, angle with the IVC > 15°, hook against the wall, and legs embedded in the IVC wall > 3 mm. The efficacy variables were fluoroscopy time, success of IVC filter withdrawal, and number of attempts to withdraw the filter. The safety variables were complications, surgical removal, and mortality. The main variable was difficult withdrawal, defined as more than 5 min fluoroscopy or more than 1 attempt at withdrawal., Results: A total of 109 patients were included; withdrawal was considered difficult in 54 (49.5%). Three radiological variables were more common in the difficult withdrawal group: hook against the wall (33.3% vs. 9.1%; p = 0.027), embedded legs (20.4% vs. 3.6%; p = 0.008), and >45 days since IVC filter placement (51.9% vs. 25.5%; p = 0.006). These variables remained significant in the subgroup of patients with OptEase IVC filters; however, in the group of patients with Celect IVC filters, only the inclination of the IVC filter >15 ° was significantly associated with difficult withdrawal (25% vs 0%; p = 0.029)., Conclusion: Difficult withdrawal was associated with time from IVC placement, embedded legs, and contact between the hook and the wall. The analysis of the subgroups of patients with different types of IVC filters found that these variables remained significant in those with OptEase filters; however, in those with cone-shaped devices (Celect), the inclination of the IVC filter >15° was significantly associated with difficult withdrawal., (Copyright © 2022 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)

La crisis de secuestro esplénico es una de las manifestaciones más frecuentes y graves de la drepanocitosis en el niño pequeño. El tratamiento clásico es la esplenectomía total, que tiene el riesgo de sepsis fulminante con una alta mortalidad. Otras complicaciones de la esplenectomía total son el aumento de la incidencia de algunas de las manifestaciones de la enfermedad y desde hace pocos años se vincula con la predisposición a eventos vasculares. En el Instituto de Hematología e Inmunología se realiza la esplenectomía parcial desde el año 1986 con excelentes resultados, pues se elimina casi en su totalidad la recurrencia de los secuestros esplénicos agudos, sin aumentar el riesgo de infecciones. Se ha demostrado que el remanente esplénico conserva su función y se desconoce el riesgo de complicaciones vasculares.Splenic sequestration crisis is one of the most frequent and serious manifestations of sickle cell disease in young children. The standard treatment is total splenectomy, which has the risk of fulminant sepsis with high mortality. Other complications of total splenectomy are the increased incidence of some of the manifestations of the disease, and since a few years ago it is associated with predisposition to vascular events. At the Institute of Hematology and Immunology partial splenectomy is performed since 1986 with excellent results, as it eliminates almost completely the recurrence of acute splenic sequestration without increasing the risk of infections. It has been demonstrated that the splenic remainder retains its function and no risk of vascular complications has been reported.

El síndrome antifosfolípido es un trastorno multisistémico adquirido y una importante causa de trombosis venosas o arteriales, así como también de morbilidad en el embarazo. Puede ser primario o secundario, este último sobre todo en pacientes con lupus eritematoso sistémico, infecciones y consumo de algunas drogas. Se exponen determinados elementos sobre sus manifestaciones clínicas y los criterios de clasificación actualizados para el diagnóstico. El tratamiento se basa en medidas de profilaxis antitrombóticas y control de los factores de riesgo asociados; pero aún muchos aspectos clínicos y de laboratorio concernientes a esta hipercoagulabilidad por la presencia de anticuerpos contra los fosfolípidos, se hallan sujetos a discusión e investigación.The antiphospholipid syndrome is an acquired multisystemic disorder and an important cause of venous or arterial thrombosis, as well as of morbidity in pregnancy. It can be primary or secondary, the last one mainly in patients with systemic lupus erythematosus, infections and consumption of some drugs. Certain elements on its clinical manifestations and the updated classification criteria for the diagnosis are exposed. The treatment is based on antithrombotic prevention measures and control of the associated risk factors; but many clinical and laboratory aspects concerning this hypercoagulability due to the presence of antibodies against phospholipids, are still under discussion and research.

Hasta el momento actual no hay ninguna recomendación basada en la evidencia sobre la sistemática a seguir de cara a mantener la permeabilidad de los accesos venosos ni prevenir la trombosis venosa en pacientes en programa de NPD. La utilización de heparina no está exenta de riesgos y de complicaciones a largo plazo. El uso de anticoagulantes también es discutido. Objetivos: Conocer la práctica habitual, en nuestro país, del mantenimiento de los catéteres venosos centrales para NPD, la incidencia de oclusión de los mismos y de trombosis venosa asociada. Métodos: estudio retrospectivo de los pacientes mayores de 18 años en activo en programa de NPD hasta noviembre de 2008, registrados por el grupo NADYA-SENPE. Resultados: Se incluyeron un total de 49 pacientes (16 hombres y 33 mujeres) pertenecientes a 6 hospitales, con una media de edad de 52,1 ± 13,9 años y una duración de la NPD de 57,4 ± 73,3 meses, con una media de 5,8 ± 1,8 días de NP a la semana. Las patologías mas frecuentes fueron enteritis rádica, alteraciones de la motilidad intestinal e isquemia mesentérica, (20,4% de pacientes cada una) y neoplasia activa (16,3%). Las principales indicaciones de la NPD fueron el síndrome de intestino corto (49,0%) y obstrucción intestinal (28,6%). Los principales factores predisponentes de trombosis venosa aparte de la neoplasia fueron: diátesis trombótica, enfermedad tromboembólica, y reposo en cama con un 6,1% cada una de ellas. El 77,6% de los pacientes recibía la NPD a través de un catéter tunelizado, y el resto a través de un reservorio implantado. Para el mantenimiento de la permeabilidad del catéter en el 28,6% de pacientes se usaba suero fisiológico y en el 69,4% heparina en distintas concentraciones retirándose ésta del catéter previa la administración de la NPT en el 63,3% de los casos. Las tasas de oclusión del catéter y episodios trombóticos fueron de 0,061/10³ y 0,115/10³ días de NPD respectivamente. Once pacientes (22,4%) recibían anticoagulación sistémica por episodios previos de trombosis venosa o tromboembolismo pulmonar. Conclusiones: La incidencia de complicaciones trombóticas asociadas al catéter en este grupo de pacientes con NPD es baja. Existe una gran heterogeneidad en la profilaxis de la oclusión del catéter y prevención de la trombosis venosa, siendo necesario unificar criterios en este sentido.In adult home parenteral nutrition (HPN) programme patients up to now no evidence-based recommendations exist on the central venous catheter maintenance nor venous thrombosis prevention. The use of heparin flushes could be linked with long term complications, besides, anticoagulants use is controversial. Objectives: To be aware of the usual maintenance practice for HPN central venous catheters, catheter occlusion and related venous thrombosis incidence in our country. Methods: Retrospective study of active HPN patients older than 18 years registered by the NADYA- SENPE working group until November 2008. Results: 49 patients were registered (16 males and 33 females), with an average age of 52.1 ± 13.9 years, belonging to 6 hospitals. HPN length was 57.4 ± 73.3 months with 5.8 ± 1.8 PN days a week. The most frequent pathologies were actinic enteritis, intestinal motility disorders and mesenteric ischemia (20.4% each), and neoplasm (16.3%). The reason for HPN provision was short bowel syndrome (49.0%), and intestinal obstruction (28.6%). Neoplasm (16.3%), thrombotic diathesis, thromboembolic syndrome and bed rest (6.1% each) were the main venous thrombosis adjuvant factors. Tunnelled catheters were used in 77.6% of patients, with implanted port-catheters in the remainder. Maintenance of the line was done with saline solution flushes (28.6%) and different concentrations of heparin solutions (69.4%). When heparin was used, it was removed before PN infusion in 63.3% of patients. Catheter occlusion and venous thrombotic events rates were 0.061/10³ and 0.115/10³ HPN days respectively. Eleven patients (22.4%) were treated with anticoagulant drugs due to previous episodes of venous thrombosis or pulmonary embolism. Conclussion: The incidence of catheter related thrombotic complications incidence is low in this group of patients on HPN. There is a great variety of practices focused on the prevention of both: line occlusion and catheter related venous thrombosis. In conclusion, it would be necessary to standardize practice.

Cerebral venous thrombosis (CVT) is an uncommon entity, accounting for up to 1% of all strokes.1,2,3 The diversity and lack of specificity on its clinical presentation may lead to delays or even failure of the diagnosis.1,3,4 In recent years, its recognition has increased due to the greater accessibility to ancillary diagnostic exams.2,5 Up to 25% of patients may present with normal cerebral computed tomography (CT), with cerebral magnetic resonance imaging (MRI) being the classic gold standard for diagnosis. Given the limited availability of MRI in the emergency department (ED) of several hospitals, Veno-CT was proved to be a reliable alternative, with no diagnostic inferiority when compared to MR.2,4,6 We describe the case of a 58-year-old woman, medicated with oral contraceptive (Estradiol + Gestodene), who resorted to the emergency department complaining of a 3-week evolution left temporal headache of increasing intensity, with no analgesic relief, associated with phono-photophobia, nausea and vomiting. She reported 2 episodes of lipothymia on the previous 2 days. There were no findings on physical objective examination, namely neurological examination. The CT scan performed revealed hemorrhage in the left cerebellar hemisphere, also indicating hyperdensity of the left lateral sinus (Fig 1). The MRI performed the next day confirmed the presence of CVT, described as extensive (Fig 2). Anticoagulation with enoxaparin was started, later on switched to warfarin. The study of thrombophilias was negative, and the only predisposing factor for CVT identified was the use of oral contraceptives. The posterior fossa has an extensive venous drainage, with several collaterals draining to multiple sinuses, which may explain the rarity of cerebellar involvement in CVT, either isolated form or with supratentorial involvement.3,4 The first line treatment is intravenous heparin, even in cases with associated hemorrhage.5

Introducción: la causa más frecuente de trombosis portal (TP) es la cirrosis hepática, mientras que los estados hipercoagulables son raramente identificados como etiología de la TP. Presentamos un caso de TP y mesentérica secundaria al déficit de la proteína S (pS). Caso clínico: paciente mujer de 74 años, que debuta con dolor abdominal difuso de 2 semanas de evolución y hemorragia digestiva alta tipo melena secundaria a varices esofágicas. En el estudio se objetiva un hígado heterogéneo, esplenomegalia y ascitis, así como una trombosis portal completa no oclusiva del hilio hepático y de sus ramas y de la vena mesentérica superior con circulación colateral. El estudio etiológico de hepatopatía fue negativo, incluyendo una biopsia hepática que mostraba cambios arquitecturales secundarios al flujo hemático disminuido compatible con hipertensión portal no cirrótica. El estudio de hipercoagulabilidad fue positivo para un déficit de proteína S. pS libre 56%, pS total 107%. Desde entonces se inició tratamiento anticoagulante sin presentar descompensaciones posteriores. Discusión: la trombosis portal suele manifestarse con síntomas inespecíficos, siendo la forma de presentación más frecuente la hemorragia digestiva alta como el caso que nos ocupa. La cirrosis es una de las causas más frecuentes de trombosis portal, sin embargo existe hasta un 65% de estos pacientes que tienen una enfermedad protrombótica asociada, como es el déficit de proteína S. Nuestro caso remarca la importancia de realizar estudios de factores trombogénicos en pacientes con TP, incluso cuando la etiología se puede atribuir a una cirrosis.Introduction: liver cirrhosis is the main cause of portal thrombosis (PT), while hypercoagulability syndromes are rarely found as the etiology of PT. We report a case of portal and mesenteric thrombosis secondary to protein S deficiency. Case report: a 74-year-old woman was admitted with melena secondary to upper gastrointestinal bleeding. She reported mild, diffuse abdominal pain in the last 2 weeks. Endoscopy revealed ruptured esophageal varices. Doppler ultrasonography and CT demonstrated a heterogeneous liver, splenomegaly and ascites, and complete non-occlusive PT involving the hilum and portal branches, as well as the superior mesenteric vein, with portosystemic collaterals. At this point a complete study for cirrhosis etiologies was negative, including a liver biopsy that showed nonspecific architectural changes secondary to diminished blood flow, which suggested non-cirrhotic portal hypertension. The search for hypercoagulability states determined a deficiency of S protein, with total pS = 107% and free pS = 56%. The patient was started on anticoagulant treatment and no other thrombotic events occurred. Discussion: PT usually manifests without specific symptoms. The most common presentation is upper gastrointestinal bleeding, as occurred in our patient. Liver cirrhosis is one of the most frequent cause of PT. Up to 65% of these patients present an associated prothrombotic state, including protein S deficiency. Our case reminds us of the importance of a systematic search for hipercoagulability syndromes in patients with TP, even when the etiology can be conferred to liver cirrhosis.

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 71-year-old man diabetic and smoker was treated with brachytherapy for a choroidal melanoma. Two years later he developed a radiation optic neuropathy and a contralateral vein occlusion. He received subtenon triamcinolone and then, he underwent a phacoemulsification surgery and one intravitreal injection of antiangiogenic, with functional and anatomical improvement. The radiation optic neuropathy is a chronic progressive vasculopathy induced by supra-threshold doses of ionizing radiation. The risk occurs when the total dose is more than 50 Gy or the daily fraction size exceeds 1,8 Gy. The vein occlusion could be related to risk factors. Several treatments have been used for radation papillopathy. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Obstetricia y Ginecología is the property of Revista Chilena de Obstetricia y Ginecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antiphospholipid syndrome is an autoimmune state of hypercoagulability caused by antibodies directed against the phospholipids of cell membranes. Objective: To describe the clinical and epidemiological characteristics of patients with a diagnosis of APS who attended in the university hospital A Price Lara. Materials and methods: Case series quantitative, descriptive, non-experimental and transversal research. Out of a population of 4636 medical records of patients, a sample of 45 medical records of patients with diagnosis of antiphospholipid syndrome was analyzed. Results: 100% of patients were female, mean age was 31.4 years old; 40 % were housewives, 13.33% secretary and another 13.33% dealer. 75.6% of patients were obstetric patients and the rest came from the rheumatology consult. The most frequent presentation was recurrent abortions in 80% of cases. Most frequent antiphospholipid syndrome was primary (68.9%) and one third of the cases required more than one type of medical treatment with low molecular weight heparin, warfarin or aspirin. Conclusion: Antiphospholipid syndrome is a disease with a wide range of clinical, immunological and epidemiological presentations that respnds to antithrombotic medication. [ABSTRACT FROM AUTHOR]

Antecedentes: La trombosis venosa y el tromboembolismo venoso son complicaciones frecuentes en los pacientes durante su hospitalización, inclusive posterior a su egreso hospitalario. Se ha documentado una mortalidad de 5 a 10% en pacientes hospitalizados con tromboembolismo pulmonar(1) y la muerte asociada a tromboembolismo venoso es la causa intrahospitalaria más común que puede ser prevenida(1-4). Objetivo General: Determinar el porcentaje de adecuado manejo de anticoagulación profiláctica en los pacientes que ingresan al HSJD, en el período de 15 de abril 2012 al 1 de junio 2012. Objetivos Específicos: Comparar las medidas de intervención en el manejo de la anticoagulación profiláctica en el HSJD, con las Guías Internacionales establecidas. Comparar los datos obtenidos con los otros Centros Hospitalarios citados en el estudio ENDORSE. Identificar los factores de riesgo más comunes para enfermedad tromboembólica. Comparar el manejo de la tromboprofilaxis de los pacientes con patologías médicas y quirúrgicas. Métodos: Se identifió los pacientes que ingresaron al HSJD, tanto a los Servicios de Cirugía y Medicina, con un intervalo no mayor a las 72 horas desde su ingreso, recopilando los datos en conjunto con la revisión de expedientes. Se valoró la indicación de tromboprofilaxis y el cumplimiento de la misma por los médicos tratantes. Resultados: Se demostró que la Sección de Medicina presenta un apego a las Guías Internacionales de tromboprofilaxis mucho mayor que la Sección de Cirugía, incluso mayor que en los estudios multinacionales (donde más bien los Servicios de Cirugía Superan a los Servicios de Medicina en este aspecto específico).

A contracepção hormonal é o método mais utilizado para prevenção de gestações não planejadas. A literatura tem demonstrado associação entre risco cardiovascular e uso de hormonioterapia. A fim de melhorar a orientação contraceptiva para mulheres com fatores de risco para doença cardiovascular, realizamos uma revisão da literatura em relação ao assunto. Esta revisão descreve os dados mais recentes da literatura científica acerca da influência dos contraceptivos hormonais em relação a trombose venosa, arterial e hipertensão arterial sistêmica, doenças cada dia mais prevalentes na população feminina jovem.

La trombosis venosa axilosubclavia es una complicación del síndrome del estrecho torácico que determina frecuentemente secuelas de hipertensión venosa crónica. El tratamiento habitual de decompresión pedicular mediante resección por vfa axilar de la primera costilla mejora la sintomatología pero no previene dichas secuelas, señalándose que el tratamiento con fibrinolíticos podrfa obtener una permeabilidad venosa adecuada a largo plazo.

Se realiza una revisión del tromboembolismo venoso en relación con el acto quirúrgico, haciendo hincapié en la detección de alteraciones congénitas o adquiridas del sistema coagulaciónlfibrinólisis. Se identificaron pacientes de "alto riesgo" para desarrollar trombosis venosas de los miembros inferiores y para ellos aconsejamos enérgicamente la realización de medidas de tromboprofilaxis. Finalmente hemos realizado una actualización del tratamiento de la trombosis establecida dejando abierta la opción de la terapia fibrinolftica como un elemento a usar, en casos seleccionados, para tratar de disminuir las secuelas posflebíticas.

Introducción: La resección quirúrgica del tumor más trombectomía es el tratamiento de elección siempre que el estado físico del paciente lo permita.Objetivos: Describir la conducta anestésica de un paciente tributario de una cirugía de alto riesgo cuya intervención quirúrgica constituye un gran desafío para cirujanos y anestesiólogos. Desarrollo: Se presenta caso clínico de paciente masculino, 59 años, con diagnóstico de hipernefroma izquierdo y trombo en vena cava inferior con extensión a aurícula derecha al que se le realizó nefrectomía radical izquierda, exposición de vena cava inferior con maniobra de “piggyback” al hígado, atriotomía derecha y cavotomía inferior para extracción de trombo, en un tiempo quirúrgico total de 7 horas y 30 minutos. El proceder se realizó bajo anestesia general con un período mínimo de bypass cardiopulmonar durante la atriotomía y liberación del trombo. Se utilizó monitorización intraoperatoria (IO) estandarizada de parámetros vitales y además ecocardiografía transesofágica para detección de embolismos y la remoción completa del trombo de la aurícula derecha. Conclusiones: La estrategia anestésica estuvo basada en la protección de las funciones renal, respiratoria, cardiovascular y cerebral. Durante el período intraoperatorio se tuvo especial cuidado para mantener cifras de pH y glicemias normales, así como euvolemia y normotermia.

Behçet's disease is a chronic multisystemic disorder, characterized by recurrent mouth and genital ulcers and uveitis. We describe the case of a 31 years- old man, with edema in his right leg due to venous thrombosis, recurrent mouth and genital ulcers, and papules-pustules on his knees. He was treated with colchicine and prednisolone. [ABSTRACT FROM AUTHOR]

Introduction. Congenital anomalies of the inferior vena cava (IVC) are the result of persistence or abnormal regression of one of the embryonic precursor veins. They are rare and usually are incidental findings that may go unnoticed. Multidetector computed tomography (MDCT) is the method of choice for diagnosis. Objectives. Review the anatomical and embryological characteristics, as well as the clinical and surgical implications, of IVC anomalies and prove the usefulness of MDCT in evaluating them. Classification. The most common IVC congenital anomalies are: a) retroaortic left renal vein, b) circumaortic left renal vein, c) double infrarenal IVC, d) left infrarenal IVC, e) continuation of IVC with azygos or hemiazygos vein, and f) absence of IVC. Each of these anomalies has different kinds of clinical and surgical implications, which include greater risk of deep venous thrombosis and/or chronic venous insufficiency and the potential risk of complications in abdominal or chest surgeries and may cause diagnostic errors in image tests. Discussion. Diagnosis of IVC anomalies allows the doctor to take the pertinent considerations based on the type (modifications in surgical techniques, complementary studies, prevention of venous thrombosis, etc.). MDCT effectively shows such anomalies, as well as associated findings such as varicose tributaries and/or thrombosis. Conclusion. Because congenital anomalies of the IVC have important clinical and surgical implications and may cause confusion in image studies, it is necessary to identify them. MDCT has been proven useful and efficient in diagnosing IVC anomalies and evaluating complications. [ABSTRACT FROM AUTHOR]

In adult home parenteral nutrition (HPN) programme patients up to now no evidence-based recommendations exist on the central venous catheter maintenance nor venous thrombosis prevention. The use of heparin flushes could be linked with long term complications, besides, anticoagulants use is controversial. Objectives: To be aware of the usual maintenance practice for HPN central venous catheters, catheter occlusion and related venous thrombosis incidence in our country. Methods: Retrospective study of active HPN patients older than 18 years registered by the NADYA- SENPE working group until November 2008. Results: 49 patients were registered (16 males and 33 females), with an average age of 52.1 ± 13.9 years, belonging to 6 hospitals. HPN length was 57.4 ± 73.3 months with 5.8 ± 1.8 PN days a week. The most frequent pathologies were actinic enteritis, intestinal motility disorders and mesenteric ischemia (20.4% each), and neoplasm (16.3%). The reason for HPN provision was short bowel syndrome (49.0%), and intestinal obstruction (28.6%). Neoplasm (16.3%), thrombotic diathesis, thromboembolic syndrome and bed rest (6.1% each) were the main venous thrombosis adjuvant factors. Tunnelled catheters were used in 77.6% of patients, with implanted port-catheters in the remainder. Maintenance of the line was done with saline solution flushes (28.6%) and different concentrations of heparin solutions (69.4%). When heparin was used, it was removed before PN infusion in 63.3% of patients. Catheter occlusion and venous thrombotic events rates were 0.061/103 and 0.115/103 HPN days respectively. Eleven patients (22.4%) were treated with anticoagulant drugs due to previous episodes of venous thrombosis or pulmonary embolism. Conclussion: The incidence of catheter related thrombotic complications incidence is low in this group of patients on HPN. There is a great variety of practices focused on the prevention of both: line occlusion and catheter related venous thrombosis. In conclusion, it would be necessary to standardize practice. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Charles Bonnet syndrome secondary to thrombosis of the longitudinal sinus with visual hallucinations and causes may be macular degeneration to occipitals lesions. We presented a case of thrombosis venous of longitudinal superior sinus. [ABSTRACT FROM AUTHOR]

Objetivo: analizar las manifestaciones clínicas de los pacientes con trombosis venosa cerebral con factores de riesgo específicos de genero (GSRF) comparado con pacientes con trombosis sin estos factores. Antecedentes: la trombosis venosa cerebral (TVC) es una causa poco frecuente de enfermedad cerebrovascular, generalmente predomina en adultos jóvenes y niños. Las manifestaciones clínicas son muy heterogéneas, lo que puede representar un desafío diagnóstico. La incidencia de TVC aumenta tres veces más en las mujeres comparado con hombres, lo que se atribuye a factores de riesgo específicos de género (GSRF) definidos como: uso de anticonceptivos orales, embarazo, puerperio o terapia de reemplazo hormonal. Métodos: estudio longitudinal retrospectivo de la cohorte prospectiva de pacientes con diagnóstico de TVC en el Instituto Nacional de Neurología y Neurocirugía, en la Ciudad de México, entre el período 2005 y 2020. Definimos los factores de riesgo específicos de género (GSRF) como: anticonceptivos orales, embarazo, puerperio o terapia de reemplazo hormonal. Los pacientes sin estos factores de riesgo se clasificaron como TVC sin GSRF. Resultados: se evaluaron 82 pacientes, 62 (75%) eran mujeres, la edad media fue 36,37 ± 12,95. En el grupo de pacientes con GSRF, 6 (30%) ingresaron en UCI y en el grupo de pacientes sin GSRF 6 (9,7%) (p = 0,025) ingresaron en UCI. Además, en el grupo de pacientes con GSFR 4 (20%) requirieron craniectomía, comparado con 2 (3,2%) en el grupo sin GSFR (p 0,012). No encontramos diferencias en la mortalidad, hemorragia intracraneal, el sitio del seno trombosado o la puntuación de la escala de Rankin modificada a los seis meses de seguimiento entre los grupos. Conclusiones: la TVC asociada a factores de riesgo específicos de género incrementa el riesgo de ingreso en la UCI y la necesidad de hemicraniectomía descompresiva en comparación con los pacientes con TVC no relacionada con GSRF. Se puede considerar un tratamiento más agresivo en estos pacientes. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archivos de Bronconeumología (English Edition) is the property of Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Supplementation with vitamin E may antagonize vitamin E in healthy adults, but it is unclear whether intake of vitamin E decreases the risk of venous thromboembolism (VTE). Methods and results: The Women's Health Study randomized 39,876 women = 45 years of age to receive 600 IU of natural source vitamin E or placebo on alternate days. Before randomization, 26,779 participants gave blood samples, which were used to determine factor V Leiden, G20210 A prothrombin, and 677C>T MTHFR polymorphisms. Documented VTE (including deep vein thrombosis or pulmonary embolism) and unprovoked VTE (no recent surgery, trauma, or cancer diagnosis) were prospectively evaluated, secondary end points of the trial. During a median follow-up period of 10.2 years, VTE occurred in 482 women: 213 in the vitamin E group and 269 in the placebo group, a significant 21% hazard reduction (relative hazard, 0.79; 95% CI, 0.66 to 0.94; p = 0.010). For unprovoked VTE, the hazard reduction was 27% (relative hazard, 0.73; 95% CI, 0.57 to 0.94; p = 0.016). In subgroup analyses, the 3% of participants who reported VTE before randomization had a 44% hazard reduction (relative hazard, 0.56; 95% CI, 0.31 to 1.00; p = 0.048), whereas women without prior VTE had an 18% hazard reduction (relative hazard 0.82; 95% CI, 0.68 to 0.99; p = 0.040). Women with either factor V Leiden of the prothrombin mutation had a 49% hazard reduction associated with vitamin E treatment (relative hazard, 0.51; 95% CI, 0.30 to 0.87; p = 0.014). Conclusions: These data suggest that supplementation with vitamin E may reduce the risk of VTE in women, and those with a prior history or genetic predisposition may particularly benefit. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)