Analysis of 19 439 lower limb amputations in children in Brazilian health system over 14 years.

Background: Amputations in children represent significant events. Few studies analyse amputations in this specific population, and most of them are old, regionalised and with small sample sizes. Besides, there are no large studies in low-income and middle-income countries.

Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery.

Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult because the absence of an aneurysm can mislead the physician to rule out rupture. Here, we describe the case of an 85-year-old male, who was undergoing oncological investigation for weight loss, inappetence, and back pain.

Association between physical activity levels and lower urinary tract symptoms: a cohort study in 20,732 Brazilian men.

Objective: This study aimed to evaluate the association between physical activity levels and lower urinary tract symptoms in 20,732 Brazilian men.

Methods: This cohort study included 20,732 men of ≥40 years of age, who participated in health screening between January 2008 and December 2018. Standardized health data (anthropometric, laboratory, clinical, and lifestyle data) were collected.

The association between erectile dysfunction and depression: a cross-sectional study of 21,139 Brazilian men.

Objective: This study aimed to investigate the relationship between depression and erectile dysfunction while controlling for sociodemographic, physical health, psychological, and lifestyle factors. Additionally, it aimed to compare erectile dysfunction with other clinical, laboratory, and behavioral variables among individuals with depression in the same population.

Methods: We included 21,139 men (≥40 years) who underwent continuous health screening in a quaternary hospital in São Paulo between January 2008 and December 2018.

Robotic endovascular peripheral arterial interventions: a proposal of a new learning model.

Objective: This study tests a suitable model for training robot-assisted peripheral vascular interventions and examines the learning curves of endovascular surgeons with different levels of previous experience and main focus of work, analyzing procedure time, fluoroscopy time, use of contrast, and radiation emission.

Methods: Sixteen endovascular surgeons with different previous experience and training performed nine manual and 18 robotic angioplasties using the CorPath GRX platform on a 3D-printed life-size immersed infragenicular arterial phantom.

Results: All participants considered the model reliable.

Electronic health record implementation: how to identify and analyze the possible negative impacts.

Objective: Identify potential negative impacts arising from implementing an electronic medical record system, classify them according to the level of criticality, and analyze method's effectiveness after implementation.

Methods: The research involved identifying the negative impacts, classifying them according to the criteria for criticality, stratifying them as high, medium, or low severity, and finally, analyzing the effectiveness of the identification and classification methods.

Results: Findings confirmed that 89.

Correlation between increased flushing intervals and malfunction and infectious complications in fully implantable catheters during the COVID-19 pandemic.

Objective: To evaluate the incidence of malfunction and colonization rates of fully implantable long-term catheters left unflushed during the COVID-19 pandemic; and to evaluate the average cost of transporting each patient to the hospital for flushing.

Methods: During the COVID-19 pandemic, patients reduced the number of hospital visits and stopped flushing their catheters periodically with saline solution. After the pandemic stabilized in 2022, patients who completed chemotherapy treatment had their long-term catheters removed.

New virtual contrast enhancement boost technique can reduce the dose of intravenous contrast medium used in computer tomography angiography of the abdominal aorta.

Purpose: This study aims to evaluate the image quality of computed tomography (CT) angiograms obtained using a virtual contrast augmentation technique, adding an iodine map to the contrast-enhanced images, obtained through a digital subtraction technique, reducing the dose of intravenous iodinated contrast medium compared to the conventional institutional standard technique.

Methods: This prospective investigation enrolled patients previously diagnosed with abdominal aortic aneurysms, who underwent two successive computed tomography angiographies (CTAs) of the aorta. One CTA was performed employing the virtual contrast enhancement boost technique with a 40% decrease in the intravenous contrast medium dose, while the other adhered to the conventional protocol without any reduction in contrast medium volume.

Robotic cardiac surgery for removal of iliac venous stent embolized in the right cardiac chambers: a case report.

A 42-year-old female patient with a surgical history of iliac venous angioplasty with stenting developed dyspnea on exertion 9 months later. Chest computed tomography angiography revealed a fractured vascular stent in the right cardiac chamber. Doppler echocardiography confirmed that the stent was anchored by the tricuspid valve, causing mild obstruction of the right ventricular filling.

Biomechanical and histological analyses of a multilayer stent in a swine model of suprarenal aortic aneurysm.

Objectives: To analyze and compare, in an animal model, the treatment of thoracoabdominal aneurysms with multilayer stents and its hemodynamic effects through the biomechanical and histological analysis of the aortic wall in contact with the stent.

Methods: Large White pigs were randomized into two groups: Stent (n=6) and Control (n=5, non-stent). All animals were subjected to the creation of a suprarenal aneurysm with a bovine pericardial patch.

Walking training decreases cardiovascular load after walking to maximal intermittent claudication in patients with peripheral artery disease.

Purpose: This study investigated whether: 1) walking training (WT) changes cardiovascular load after walking until maximal intermittent claudication (IC) in patients with peripheral artery disease (PAD); and 2) acute and chronic cardiovascular responses to walking were related to each other.

Methods: A randomized, controlled, parallel-group design was employed. Thirty-two men with PAD and IC were randomly assigned to one of two groups: WT (n=16) or control (CO, n=16) twice a week for 12 weeks.

Association between physical activity performed at different intensities and cardiovascular health in patients with peripheral artery disease: an observational study.

Background: We examined the sedentary behavior and physical activity of 260 patients with peripheral artery disease. Women engaged in more light physical activity than men did. Light physical activity was associated with lower arterial stiffness in men only, while no significant associations were found between sedentary behavior, moderate-vigorous physical activity, and cardiovascular outcomes.

Physical activity levels are associated with depressive symptoms: A cross-sectional study of 58,445 adults.

Introduction: Depression is the leading cause of mental health-related illnesses and disabilities. Physical activity (PA) has been included as part of therapeutic approaches for patients with depression. This study aimed to investigate the associations between depressive symptoms and PA levels in a large representative cohort of Brazilian adults and older individuals.

Does frailty affect barriers to physical activity in patients with symptomatic peripheral artery disease? A cross-sectional study.

Background: Frailty syndrome is prevalent among many patients experiencing intermittent claudication symptoms. Considering that components of the frailty syndrome can affect both physical and psychological functions, it is likely that barriers to physical activity are heightened in these individuals.

Aim: To analyze the association between barriers to physical activity and frailty in patients with symptomatic peripheral artery disease (PAD).

Rivaroxaban for Patients with Intermittent Claudication.

Background: The combination of rivaroxaban plus aspirin compared with aspirin alone reduces the risk of major adverse cardiovascular and limb events for high-risk patients with peripheral artery disease. It is unknown whether rivaroxaban plus aspirin improves intermittent claudication for adults with lower-risk peripheral arterial disease.

Methods: In this randomized, open-label, multicenter, 24-week clinical trial, we randomly assigned patients with peripheral artery disease and intermittent claudication to receive either 2.

Association of mental health with walking capacity in patients with claudication: a cross-sectional study.

Objectives: The purpose of this investigation was to verify the association between mental health (MH) indicators with walking capacity in patients with PAD.

Methods: Two hundred and forty-six patients with PAD and claudication symptoms participated in this study. Physical function was assessed objectively with the 6-min walk test (6MWT) and subjectively using the Walking Impairment Questionnaire (WIQ).

Guideline-Based Telemedicine Assessment of Orthopedic Low-Risk Conditions by General Practitioners is Not Inferior to that of Face-to-Face Consultations with Specialists in the Emergency Department: A Randomized Trial.

There is a lack of randomized controlled trials focusing on orthopedic telemedicine (TM). The objective of this research was to compare the diagnostic accuracy and pattern of TM consultations of low-risk orthopedic patients performed by general practitioners (GPs) with those of face-to-face evaluations by orthopedists at an emergency department (ED). This randomized, single-center study was conducted between October 2021 and November 2022 on patients at an ED.

Preoperative evaluation profile of patients undergoing arterial vascular surgery in a tertiary hospital.

Background: Patients with peripheral arterial disease have an increased risk of developing cardiovascular complications in the postoperative period of arterial surgeries known as Major Adverse Cardiac Events (MACE), which includes acute myocardial infarction, heart failure, malignant arrhythmias, and stroke. The preoperative evaluation aims to reduce mortality and the risk of MACE. However, there is no standardized approach to performing them.

Dynamic computed tomography angiography for noninvasive diagnosis of bow Hunter's syndrome: a case report.

The focus of this case report is to technically describe a noninvasive diagnostic evaluation of bow Hunter's syndrome using a dynamic computed tomography angiography protocol and discuss its advantages. In addition, we aimed to exemplify the quality of the study by presenting images of a 3D-printed model generated to help plan the surgical treatment for the patient. The dynamic computed tomography angiography protocol consisted of a first image acquisition with the patient in the anatomic position of the head and neck.

Robotic-Assisted Endovascular Treatment for Transplant Renal Artery Stenosis: A Feasibility Study.

Purpose: To describe a single-center experience with robotic-assisted endovascular treatment for transplant renal artery stenosis.

Materials And Methods: This is a single-center, retrospective, feasibility study of 4 consecutive cases of robotic-assisted endovascular surgery for transplant renal artery stenosis from October 2021 to August 2022.

Results: All lesions were identified, and stenting was performed with no complications.

The bodyweight walking distance product and its relationship with clinical markers in patients with symptomatic peripheral artery disease.

Purpose: The six-minute walk test (6MWT) is extensively employed to evaluate gait impairment in patients with symptomatic peripheral artery disease (PAD) and has been associated with different health outcomes. However, various approaches exist for calculating and interpreting the six-minute test in order to address the needs of patients more effectively. Therefore, we investigated how these different approaches correlate with functional capacity and cardiovascular health in patients with symptomatic PAD.

Retrospective analysis of 1,203 cases of referral to a quaternary vascular surgery outpatient clinic within the Unified Health System, São Paulo, Brazil.

Objective: Through a retrospective analysis of 1,203 cases of referral from primary healthcare units to a specialized quaternary vascular surgical service, the findings of this study revealed a high proportion of inappropriate referrals, which may represent a substantial subutilization of this highly complex service. Consequently, in this study, we aimed to evaluate 1,203 cases of referral to a quaternary vascular surgical service, in São Paulo, Brazil, over a 6-year period, to assess the appropriate need for referral; in addition to the prevalence of surgical indications.

Methods: In this retrospective analysis, we reviewed the institutional records of participants referred from Basic Healthcare Units to a vascular surgical service inside the Brazilian Unified Health System, between May 2015 and December 2020.

Robot-assisted endovascular treatment of hepatic artery aneurysm: A case report.

Objective: Robot-assisted endovascular surgery has emerged as a new alternative to interventional procedures, with its application expanding to peripheral and visceral approaches. The objective of this paper is to describe a robot-assisted endovascular treatment in splanchnic arteries.

Methods: A case report of an asymptomatic male patient with an incidental finding of a saccular aneurysm of the proper hepatic artery measuring 3.