Ultrasound-guided foam sclerotherapy for severe chronic venous insufficiency

ABSTRACT Chronic venous insufficiency is characterized by cutaneous alterations caused by venous hypertension; in severe forms, it progresses to lower limb ulcers. Lower limb varicose veins are the main cause of chronic venous insufficiency, and the classic treatment includes surgery and compressive therapy. Minimally invasive alternative treatments for varicose veins include new techniques such as venous thermal ablation using laser or radiofrequency. The use of different methods depends on clinical and anatomical factors. Ultrasound-guided foam sclerotherapy is the venous injection of sclerosing foam controlled by Doppler ultrasound. Sclerotherapy is very useful to treat varicose veins, and probably, is cheaper than other methods. However, until the present, it is the less studied method

Traumatic arteriovenous fistula of the superficial temporal artery

Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula

HYDROCORTISONE SUPRESSES INFLAMMATORY ACTIVITY OF METALLOPROTEINASE-8 IN CAROTID PLAQUE

AbstractObjective:Matrix metalloproteinases are inflammatory biomarkers involved in carotid plaque instability. Our objective was to analyze the inflammatory activity of plasma and carotid plaque MMP-8 and MMP-9 after intravenous administration of hydrocortisone.Methods:The study included 22 patients with stenosis ≥ 70% in the carotid artery (11 symptomatic and 11 asymptomatic) who underwent carotid endarterectomy. The patients were divided into two groups: Control Group - hydrocortisone was not administered, and Group 1 - 500 mg intravenous hydrocortisone was administered during anesthetic induction. Plasma levels of MMP-8 and MMP-9 were measured preoperatively (24 hours before carotid endarterectomy) and at 1 hour, 6 hours and 24 hours after carotid endarterectomy. In carotid plaque, tissue levels of MMP-8 and MMP-9 were measured.Results:Group 1 showed increased serum levels of MMP- 8 (994.28 pg/ml and 408.54 pg/ml, respectively; P=0.045) and MMP-9 (106,656.34 and 42,807.69 respectively; P=0.014) at 1 hour after carotid endarterectomy compared to the control group. Symptomatic patients in Group 1 exhibited lower tissue concentration of MMP-8 in comparison to the control group (143.89 pg/ml and 1317.36 respectively; P=0.003). There was a correlation between preoperative MMP-9 levels and tissue concentrations of MMP-8 (P=0.042) and MMP-9 (P=0.019) between symptomatic patients in the control group.Conclusion:Hydrocortisone reduces the concentration of MMP- 8 in carotid plaque, especially in symptomatic patients. There was an association between systemic and tissue inflammation

Hidrocortisona reduz as concentrações séricas dos biomarcadores inflamatórios séricos em pacientes submetidos a endarterectomia de carótida

ResumoContextoA hidrocortisona pode reduzir a concentração dos biomarcadores inflamatórios séricos e teciduais.ObjetivoAnalisar a atividade inflamatória da proteína C-reativa ultrassensível (PCR-US), do fator de necrose tumoral (FNT)-alfa e do fator de crescimento do endotélio vascular (FCEV) séricos e teciduais, mediante administração intraoperatória de hidrocortisona, após endarterectomia de artéria carótida (EAC).MétodoVinte e dois pacientes foram divididos em Grupo Controle (5 assintomáticos e 6 sintomáticos) – não foi administrada hidrocortisona – e Grupo 1 (4 assintomáticos e 7 sintomáticos) – foram administrados 500 mg intravenoso de hidrocortisona. O PCR-US, o FNT-alfa e o FCEV séricos foram dosados no pré-operatório e em 1 hora, 6 horas e 24 horas após a EAC. Na placa carotídea, mensuramos os níveis de FNT-alfa e FCEV.ResultadosO grupo 1 exibiu menor concentração sérica de FNT-alfa em 1 hora (p=0,031), 6 horas (p=0,015) e 24 horas (p=0,017) após a EAC, e menor concentração de FCEV em 1 hora (p=0,006) e 6 horas (p=0,005) após a EAC, em relação ao grupo controle. Os pacientes sintomáticos do grupo 1 exibiram menor concentração de FNT-alfa em 1 hora e 6 horas após a EAC, e menor concentração de FCEV em 1 hora após a EAC, em relação ao grupo controle. Não houve diferença estatística entre as concentrações teciduais de FNT-alfa e FCEV entre o grupo controle e o grupo 1.ConclusãoA hidrocortisona reduz as concentrações séricas pós-operatórias de FNT-alfa e FCEV, em especial nos sintomáticos; porém, não reduz os níveis teciduais destes biomarcadores

Carbono orgânico e nitrogênio total do solo e suas relações com os espaçamentos de plantio de cafeeiro Soil organic carbon and total nitrogen as related with coffee spacing

A densidade de plantio e o arranjo das plantas exercem influência sobre a produção de resíduos vegetais nos agroecossistemas cafeeiros. Esse aporte diferenciado de resíduos regula os teores de C e N do solo. Este trabalho objetivou avaliar os teores de C orgânico e de N total em um Latossolo Vermelho distrófico cultivado com cafeeiro com diversos espaçamentos de plantio. O experimento foi conduzido no período de 1992 a 2004 na Fazenda Experimental da EPAMIG, em Machado (MG). Os tratamentos avaliados consistiram da combinação de quatro espaçamentos entre linhas (2,0; 2,5; 3,0; e 3,5 m), três espaçamentos entre plantas (0,5; 0,75; e 1,0 m) e dois sistemas de manejo dos resíduos culturais (entrelinha - EL e projeção da copa - PC), totalizando 24 tratamentos, dispostos no campo em blocos ao acaso, em esquema fatorial 4 x 3 x 2, com três repetições. Foram avaliados os teores de C orgânico (CO) e de N total do solo (NT), além da relação CO/NT. Nas amostras de solo da EL, os teores de CO e NT foram maiores do que os da PC. O espaçamento de plantio influenciou os teores de CO, com os maiores valores, em geral, no espaçamento de 3,5 m entre as linhas de plantio, quando a distância entre plantas foi de 0,5 e 0,75 m, na profundidade de 0-0,05 m. O maior acúmulo de resíduos vegetais, o menor revolvimento do solo e, conseqüentemente, os maiores teores de matéria orgânica favorecem a ocorrência de maiores teores de CO e NT na EL. A retirada da mata e o cultivo do solo com cafeeiro por 11 anos resultou em decréscimo nos teores de CO de 26 % a 38 % na EL e na PC, respectivamente, e diminuição média de 25 % nos teores de NT.<br>The density and arrangement of trees influences the production of plant residues in coffee agroecosystems. This differentiated input of biomass regulates the contents of soil-C and -N. This study aimed to evaluate the contents of organic C and total N in a Typic Hapludox, in different spacings of (Coffea arabica L.) trees and tree rows. The experiment was carried out from 1992 to 2004 on an experimental farm of EPAMIG, in Machado (Minas Gerais State, Brazil). The treatments consisted of the combination of four distances between tree rows (2.0; 2.5; 3.0 and 3.5 m), three in-row distances (0.5; 0.75 and 1.0 m) and two management systems of crop residues (interline - IL and canopy projection - CP), totaling 24 treatments, arranged randomly in the field in blocks, in 4x3x2 factorial design, with three replications. The soil organic carbon (OC) and total nitrogen (TN) contents were measured, apart from the OC/TN ratio. In samples collected in IL, the OC and TN contents were higher than those measured in CP. The cropping spacing influenced the OC contents; highest values were verified when distance between rows was 3.5 m and in-row distances 0.75 and 0.5 m, in the 0-0.05 m layer. Higher accumulation of plant residues, low soil disruption, and, consequently, higher contents of organic matter favors more OC and TN in the IL. Deforestation and coffee cropping for 11 years resulted in decreasing OC contents from 26 % to 38 %, in IL and CP, respectively, and an average reduction of 25 % for TN