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  • Wiggins McKinney posted an update 1 day, 20 hours ago

    Visceral and renal artery aneurysms are rare (0.01 to 2%) and their risk of rupture varies between different types and depending on their anatomy and patient context (comorbidities, pregnancy, and liver transplant history). Etrasimod cost Mortality due to rupture of these aneurysms is around 25%. New techniques and materials derived from neurointervention seem to be promising options for treatment of these aneurysms. In this context, we report the case of a patient undergoing endovascular treatment of both splenic artery and renal artery aneurysms during the same procedure, using Solitaire stents and controlled release coils in both repairs. The patient recovered well with both aneurysms adequately treated. In conclusion, endovascular treatment of splenic and renal artery aneurysms during the same operation is feasible and has proved safe and effective in the case reported.Vitamin D (1,25-dihydroxycolecalciferol) is a prohormone that has attracted the interest of researchers since studies have shown that its effects are not restricted to bone metabolism. Thus, the present review summarizes the most recent findings and discusses the usefulness of prescribing vitamin D and its analogues for treatment and prevention of cardiovascular disorders and endothelial dysfunction. The paper constitutes a narrative review of the literature, selecting articles published from 2012 to 2019. Studies have shown that vitamin D3 and its analogues have beneficial effects on endothelial function, but these results are controversial, since research with larger samples and of longer duration found no reduction in morbidity and mortality or cardiovascular risk factors after use of these substances. Given the current state of the art, there is no clear scientific basis for supplementation with vitamin D or its analogues for treatment of endothelial dysfunction or cardiovascular disease.Uterine Artery Embolization (UAE) is a noninvasive alternative to open surgery for treatment of uterine myomatosis. This study aims to analyze the efficacy and safety of UAE in these cases. A systematic review was carried out of studies available on the Medline (via PubMed) and the LILACS and PEDro (via the Biblioteca Virtual em Saúde) databases. The searches found 817 studies, 7 of which were selected according to the eligibility criteria (analytical, longitudinal, retrospective, or prospective studies), with a total of 367 patients studied. The variables analyzed and the characteristics of the studies included were collated and input to a database. Rates of volume reduction of the uterus and the dominant myoma were 44.1% and 56.3%, respectively. Mean rate of complete infarction of the dominant myoma was 88.6% (82-100%). The mean number of complications observed was 15±8.6 cases, most of which were classified as minor, and no deaths were recorded. The mean number of re-interventions in absolute values was 12.2±15.5 cases. Therefore, in the literature analyzed, uterine artery embolization is an effective procedure with a low rate of complications for treatment of uterine leiomyomatosis.In countries that have controlled classic causes of maternal death, such as eclampsia and hemorrhage, venous thromboembolism (VTE) has become the major concern. Prevention of VTE during pregnancy and postpartum by applying guidelines and implementing pharmacoprophylaxis is still the best strategy to reduce occurrence of this complication. Hormonal contraceptives and hormone replacement therapy also increase the risk of VTE, but women cannot be deprived of their benefits, which increase their freedom at childbearing age and reduce their symptoms at menopause. Both indiscriminate use and unmotivated prohibition are inappropriate. Contraceptive and hormone replacement methods should be chosen with care, evaluating the patients’ contraindications, eligibility criteria, and autonomy. This article presents a nonsystematic review of recent literature with the aim of evaluating and summarizing the associations between VTE and clinical situations peculiar to women.

    Ischemia-reperfusion injury contributes to morbidity after revascularization procedures. Along with early reperfusion, tissue conditioning by alternating intervals of brief ischemia-reperfusion episodes is considered the best approach to limit tissue damage. Remote ischemic conditioning is conducted remotely, in tissues other than those under ischemia. Despite this, remote ischemic conditioning protection mechanisms are poorly understood, which can lead to misapplication.

    To assess whether remote ischemic conditioning works in the heart and brain through enhancement of cells’ antioxidant defenses and whether the response is sustained or temporary.

    Twenty-one male Wistar rats were assigned to three groups (n = 7) SHAM same procedure as the other groups, but no remote ischemic conditioning was carried out. RIC 10 heart and brain were harvested 10 minutes after the remote ischemic conditioning protocol. RIC 60 heart and brain were harvested 60 minutes after the remote ischemic conditioning protocol. The remote ischemic conditioning protocol consisted of 3 cycles of 5 min left hindlimb ischemia followed by 5 min left hindlimb perfusion, lasting 30 min in total. Heart and brain samples were used to measure the tissue antioxidant capacity.

    Remote ischemic conditioning increased heart and brain antioxidant capacity after 10 minutes (0.746 ± 0.160/0.801 ± 0.227 mM/L) when compared to SHAM (0.523 ± 0.078/0.404 ± 0.124 mM/L). No enhancement of heart or brain antioxidant capacity was detected 60 minutes after remote ischemic conditioning (0.551 ± 0.073/0.455 ± 0.107 mM/L).

    Remote ischemic conditioning temporarily enhances heart and brain antioxidant defenses in male Wistar rats.

    Remote ischemic conditioning temporarily enhances heart and brain antioxidant defenses in male Wistar rats.

    Use of electronic protocols for data collection and storage enables clinical research to be conducted dynamically, contributing to medical advances.

    To create an electronic data base for collection of clinical and surgical data on chronic venous insufficiency (CVI), to facilitate production of scientific studies.

    Initially, a database was constructed by means of a bibliographic review of text books and relevant scientific articles for all vascular diseases and then a database on CVI was extracted. These data were computerized using the Integrated Electronic Protocols System (SINPE©) and then assessed in a pilot project.

    The multidisciplinary electronic protocol for vascular diseases covered the following items history taking, physical examination, work-up tests, types of treatment, and progression. Using these items, a master protocol was created containing 6,145 items, and then a CVI-specific protocol containing 2,877 items was compiled. The protocol’s functionality was tested in a pilot project, collecting data from medical records.

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