A hiper-homocisteinemia, resultante da deficiência na conversão da homocisteína em cistationina, constitui em fator de risco isolado para doenças vasculares. A mutação 844ins68 do gene da cistationina beta-sintetase é um fator adicional de risco para a trombose venosa profunda. O objetivo deste estudo foi avaliar a freqüência da mutação 844ins68 do gene da cistationina beta-sintetase em pacientes com trombose venosa profunda. Foram avaliados em estudo caso-controle 95 pacientes com trombose venosa profunda, a presença da mutação 844ins68 no éxon 8 do gene da cistationina beta-sintetase. Como critério de inclusão foi adotada a presença de trombose venosa profunda confirmada pelo dúplex ou flebografia. O grupo controle constituiu-se de 95 doadores de sangue, sem história familiar prévia de trombose venosa, com sexo, grupo étnico e idades pareados aos do grupo de estudo. Foram coletados 5 mL de sangue venoso com o uso de anticoagulante EDTA de cada participante. O DNA foi extraído dos leucócitos pelo método DTAB e CTAB. A detecção da mutação do gene foi realizada por amplificação de um segmento gênico por PCR, com iniciadores que flanqueiam a região de inserção e com revelação em gel de agarose a 2%, corado com brometo de etídio, sob luz UV. O fragmento correspondente ao alelo normal contém 184 pares de base e o correspondente ao alelo mutante, 252 pares de base. O teste exato de Fisher foi utilizado na análise dos resultados. A condição heterozigota para a mutação foi encontrada em 14,73% dos pacientes e em 3,1% dos indivíduos do grupo controle (p = 0,009). A freqüência do alelo mutante mostrou diferença significativa (p = 0,01), sendo 0,074 para os pacientes versus 0,016 para o grupo controle. Não foram encontrados casos de homozigose.

Hyperhomocysteinemia, resulting from a deficiency in the conversion of homocysteine to cystathionine, constitutes an independent risk factor for vascular diseases. The 844ins68 mutation of the cystathionine-beta-synthetase gene is an additional risk factor for deep venous thrombosis. The aim of this study was to evaluate the frequency of the 844ins68 mutation of the cystathionine-beta-synthetase gene in deep venous thrombosis. In a case control study, 95 patients with deep venous thrombosis were evaluated in respect to the presence of the 844ins68 mutation on exon 8 of the cystathionine-beta-synthetase gene. The inclusion criterion included the presence of deep venous thrombosis confirmed by duplex or phlebography. A control group was formed consisting of 95 blood donors, without previous history of venous thrombosis with data such as gender, age and race similar to the study group. Five milliliters of venous blood were collected in EDTA anticoagulant from all the members of both groups. The DNA was extracted from the leukocytes by te DTAB and CTAB methods. Detection of the gene mutation was made by amplification by PCR, using primers for the insertion region and observed by 2% agarose gel electrophoresis using ethidium bromide stain. The fragment corresponding to the normal allele contains 184 base pairs and the mutant allele 252 base pairs. The Fisher exact test was utilized in the analysis of the results. Heterozygote individuals for the mutation were evidenced in 14.73% of the patients and in 3.1% of the control group (p-value = 0.009). The frequency of the mutant allele demonstrated a significant difference (0.074 for the patients versus 0.016 for the control group) (p-value = 0.01). No homozygotic individuals were found.

Nasal haemorrhage or nosebleed, is the most common of haemorrhages due to the intense vasculization of the nose, the fragility of the nasal mucous membrane and its vulnerability to traumas and irritant agents. The aim of this study is to report on a reduction of episodes of nosebleed in two patients with the use of amnophtone. A 34-year-old male patient and a 44- year-old female patient presented with histories of two or more nosebleeds per week, despite treatment during the acute phase. They both sought medical assistance for other vascular complaints, which were suggestive of vascular insufficiency as, during the physical examination petechia lesions in the lower limbs were detected. They were treated with 75 mg of amnaphtone three times daily. One week after, at the follow-up, they reported an improvement of the vascular symptoms, however, more markedly was the significant improvement in relation to the nosebleeds which were frequent but had not been reported in the first consultation. In conclusion, amnaphtone demonstrated to be efficient in the prevention of recurrence of nosebleed in these patients.

A oxigenação extracorpórea por membrana é uma técnica de suporte cardiopulmonar prolongado, com finalidade de auxiliar o pulmão e/ou o coração, quando os mesmos entram em falência não responsiva aos tratamentos convencionais não invasivos. O objetivo do presente estudo foi avaliar as alterações hematimétricas durante 12 horas de ECMO em estudo animal. Foram estudados 11 ovinos, da raça Santa Inês, sendo seis machos e cinco fêmeas, com peso entre 5,4 e 15kg (12,2 ± 3,1kg). Nos cinco primeiros animais, o prime do circuito extracorpóreo foi feito com solução de Ringer com lactato de sódio (Ringer-Lactato Glicolabor - Ribeirão Preto - SP) e solução de gelatina a 3,5% (Hisocel - Campinas - SP), na proporção de 2:1, no total de 750ml. No sexto animal foi diminuído o volume do prime para 450ml, sendo 250ml de solução de Ringer com lactato de sódio e 200ml de solução de gelatina a 3,5%. Nos cinco últimos experimentos (casos 7 a 11), empregou-se 250ml de sangue fresco total anticoagulado com citrato de sódio e 200ml de Ringer com lactato de sódio. Os exames realizados foram: hematócrito, hemoglobina, leucócitos, plaquetas, albumina e globulina. No estudo estatístico foram empregados os testes de Mann-Whitney e Análise da Variância e, no caso deste último demonstrar variação significativa (p<0,05), aplicou-se o teste de Tukey. Foi detectada redução em todos elementos analisados e com diferença estatística entre o grupo 1 e 2 no hematócrito e leucócitos. A oferta excessiva de volume desencadeou alterações hematimétricas em estudo experimental utilizando a ECMO em carneiro.

Extra-corporeal membrane oxygenation is a technique of prolonged cardiopulmonary support, with the objective of assisting the lungs and/or heart when they start to fail and do not respond to conventional non-invasive treatment. The aim of this study was to evaluate hematological alterations during 12 hours of extra-corporeal membrane oxygenation in animals. Eleven sheep, six males and five females, of the Santa Inês breed with weights ranging from 5.4 to 15kg (12.2±3.1kg) were studied. With the first five animals, Ringer solution with sodium lactate (Ringer - Lactato Glicolabor - Ribeirão Preto - SP) and a 3.5% gelatine solution (Hisocel - Campinas -SP) were used to prime the extra-corporeal circuit in the proportion of 2:1 making a total of 750ml. In the sixth animal the volume of the circuit primer was reduced to 450ml, composed of 250ml of Ringer solution with sodium lactate and 200ml of 3.5% gelatine solution. In the other 5 animals 250ml of total fresh blood anticoagulated with sodium citrate and 200ml of Ringer solution with sodium lactate were employed. The blood tests performed were: hematocrit, haemoglobin, leukocytes, platelets, albumin and globulin. Mann-Whitney and variation analysis tests were used for statistical evaluation and, in the case that the variation analysis gave a significant difference (p < 0.05), the Tukey test was applied. A reduction of all the elements analysed was observed with a significant statistical difference in the values of hematocrit and leukocytes between the two groups. The hematological alterations seen in this study were exclusively due to the excessive supply of fluid volumes.