Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4318245 http://repositorio.unifesp.br/handle/11600/46806 |
Resumo: | Objectives: The purposes of this study were: to evaluate cerebral blood flow velocities and vasoreactivity using transcranial Doppler (TCD) in children with SCD and to compare them with healthy subjects; to compare cerebral blood flow velocities and vasoreactivity with TCD in children with SCD, with and without migraine, and healthy subjects; to determine headache and migraine frequencies in children with SCD. Methods: Children aged 10 to 18 years old with SCD were evaluated from the hemoglobinopathy clinics at UNIFESP. Healthy children of similar age and gender were included. A structured questionnaire was applied to all patients evaluating the presence of headache, its frequency and if migraine criteria were fulfilled. Demographic characteristics, comorbidities, medication use, laboratory and imaging exams data were collected from medical records. TCD was performed in all patients and controls subjects, with breath-holding maneuver and calculation of the breathholding index (BHI) to assess cerebral vasoreactivity. Cerebral blood flow velocities were assessed in both middle, anterior, posterior, vertebrals and basilar arteries. Cerebral blood flow velocities and vasorreactivity were compared between patients and control subjects and also between patients with SCD with and without migraine and healthy controls. Statistical analyses were performed using SPSS 18.0. Results: TCD was performed in 42 patients, mean age 12,67?2,18 years, and 20 controls subjects, mean age 13,90?3,04 years. Blood flow velocities were higher in patients with SCD than health volunteers in all arteries evaluated. Cerebral blood flow velocities were negatively correlated with hemoglobin levels (p<0,05). BHI was abnormal in 19% of the patients and in none of the controls (p=0.04). BHI values in patients were significantly lower than in control subjects (p<0.01 at right and p=0.01 at left). There were no differences in blood flow velocities between patients with or without migraine. BHI was similar in children with SCD with or without migraine, and between both and control subjects. A total of 57,1% had headache and 38% fulfilled criteria for migraine Conclusions: Cerebral vasoreactivity may be impaired in children with SCD, with BHI significantly lower in this group, maybe reflecting a low vascular reserve and autoregulation capacity in these patients. Cerebral vasoreactivity was not different between patients with or without migraine and both and controls subjects. Migraine was found in more than one third of our patients. |
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Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcranianoCerebral vasoreactivity study in children with sickle cell disease: a transcranial Doppler evaluationFalciform anemiaCerebral vascular reactivityMigraineTranscranial dopplerBreath-holdinDoença falciformeVasorreatividade cerebralMigraneaDoppler transcranianoBreath-holdingObjectives: The purposes of this study were: to evaluate cerebral blood flow velocities and vasoreactivity using transcranial Doppler (TCD) in children with SCD and to compare them with healthy subjects; to compare cerebral blood flow velocities and vasoreactivity with TCD in children with SCD, with and without migraine, and healthy subjects; to determine headache and migraine frequencies in children with SCD. Methods: Children aged 10 to 18 years old with SCD were evaluated from the hemoglobinopathy clinics at UNIFESP. Healthy children of similar age and gender were included. A structured questionnaire was applied to all patients evaluating the presence of headache, its frequency and if migraine criteria were fulfilled. Demographic characteristics, comorbidities, medication use, laboratory and imaging exams data were collected from medical records. TCD was performed in all patients and controls subjects, with breath-holding maneuver and calculation of the breathholding index (BHI) to assess cerebral vasoreactivity. Cerebral blood flow velocities were assessed in both middle, anterior, posterior, vertebrals and basilar arteries. Cerebral blood flow velocities and vasorreactivity were compared between patients and control subjects and also between patients with SCD with and without migraine and healthy controls. Statistical analyses were performed using SPSS 18.0. Results: TCD was performed in 42 patients, mean age 12,67?2,18 years, and 20 controls subjects, mean age 13,90?3,04 years. Blood flow velocities were higher in patients with SCD than health volunteers in all arteries evaluated. Cerebral blood flow velocities were negatively correlated with hemoglobin levels (p<0,05). BHI was abnormal in 19% of the patients and in none of the controls (p=0.04). BHI values in patients were significantly lower than in control subjects (p<0.01 at right and p=0.01 at left). There were no differences in blood flow velocities between patients with or without migraine. BHI was similar in children with SCD with or without migraine, and between both and control subjects. A total of 57,1% had headache and 38% fulfilled criteria for migraine Conclusions: Cerebral vasoreactivity may be impaired in children with SCD, with BHI significantly lower in this group, maybe reflecting a low vascular reserve and autoregulation capacity in these patients. Cerebral vasoreactivity was not different between patients with or without migraine and both and controls subjects. Migraine was found in more than one third of our patients.Objetivos: Os objetivos do presente estudo foram: avaliar as velocidades de fluxo sanguíneo assim como a vasorreatividade cerebral através do Doppler transcraniano (DTC) em crianças com doença falciforme e comparar com um grupo controle de voluntários saudáveis. Comparar as velocidades de fluxo sanguíneo e a vasorreatividade cerebral através do Doppler transcraniano em crianças com doença falciforme, com e sem migrânea, e com um grupo de voluntários saudáveis. Determinar a frequência de migrânea em crianças com doença falciforme. Métodos: Foram selecionados pacientes de 10 a 18 anos acompanhados no ambulatório de hemoglobinopatias da UNIFESP com o diagnóstico de doença falciforme. Voluntários saudáveis pareados por sexo e idade foram avaliados. Os pacientes foram questionados quanto à queixa de cefaleia, a sua frequência e se preenchiam critérios para migrânea. Dados demográficos, comorbidades, uso de medicações e exames laboratoriais e de imagem foram colhidos dos prontuários dos pacientes. Pacientes e voluntários foram submetidos ao DTC, com realização de manobra de apneia e cálculo de breath-holding index (BHI) para avaliação da vasorreatividade cerebral. Foram avaliadas as velocidades de fluxo sanguíneo nas artérias cerebrais médias (ACM), anteriores, posteriores, vertebrais e basilar. As velocidades de fluxo e a vasorreatividade foram comparadas entre os pacientes e controles, bem como entre pacientes, com e sem migrânea, e com o grupo controle através dos testes t de student, Mann Whitney e chi quadrado. As análises estatísticas foram realizadas no programa SPSS 18.0. Resultados: Foram avaliados 42 pacientes, idade média 12,67?2,18 anos, e 20 voluntários saudáveis, idade média 13,90?3,04 anos. As velocidades de fluxo encontradas em pacientes com DF foram significativamente maiores do que os controles em todos os segmentos arteriais avaliados. As velocidades de fluxo nos pacientes tiveram uma correlação negativa com os valores de hemoglobina (p<0,01). A vasorreatividade estava alterada em 19% dos pacientes e em nenhum dos controles (p=0.04). Os valores de BHI dos pacientes foram significativamente menores que a dos controles (p<0.01 à direita e p=0.01 à esquerda). Não houve diferença de velocidades de fluxo nas ACMs entre os pacientes com e sem migrânea. Comparando-se o BHI entre os pacientes com e sem migrânea também não houve diferença. A queixa de cefaleia esteve presente em 57,1% dos pacientes e a frequência de migrânea nos pacientes foi de 38%. Conclusões: A vasorreatividade cerebral pode estar comprometida em pacientes com doença falciforme, quando avaliada através do DTC e BHI, o que pode ser reflexo da pouca reserva vascular e da perda da capacidade de autorregulação nesses pacientes. Não houve diferença entre as velocidades de fluxo sanguíneo cerebral entre em crianças com DF com ou sem migrânea. A vasorreatividade cerebral também foi semelhante quando comparada entre pacientes com DF com e sem migrânea e pacientes voluntários saudáveis. Mais de um terço dos pacientes avaliados preenchiam critérios para migrânea.Dados abertos - Sucupira - Teses e dissertações (2013 a 2016)Universidade Federal de São Paulo (UNIFESP)Silva, Gisele Sampaio [UNIFESP]http://lattes.cnpq.br/6812788681744190http://lattes.cnpq.br/7204169771610580Universidade Federal de São Paulo (UNIFESP)Campos, Rejane de Souza Macêdo [UNIFESP]2018-07-27T15:50:53Z2018-07-27T15:50:53Z2016-10-25info:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/publishedVersion80 f.application/pdfhttps://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4318245CAMPOS, Rejane de Souza Macêdo. Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano. 2016. 80 f. Dissertação (Mestrado em Neurologia - Neurociências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016.Rejane de Souza Macêdo Campos - PDF A.pdfhttp://repositorio.unifesp.br/handle/11600/46806porSão Pauloinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-09T00:26:23Zoai:repositorio.unifesp.br/:11600/46806Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-09T00:26:23Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano Cerebral vasoreactivity study in children with sickle cell disease: a transcranial Doppler evaluation |
title |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
spellingShingle |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano Campos, Rejane de Souza Macêdo [UNIFESP] Falciform anemia Cerebral vascular reactivity Migraine Transcranial doppler Breath-holdin Doença falciforme Vasorreatividade cerebral Migranea Doppler transcraniano Breath-holding |
title_short |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
title_full |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
title_fullStr |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
title_full_unstemmed |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
title_sort |
Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano |
author |
Campos, Rejane de Souza Macêdo [UNIFESP] |
author_facet |
Campos, Rejane de Souza Macêdo [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Silva, Gisele Sampaio [UNIFESP] http://lattes.cnpq.br/6812788681744190 http://lattes.cnpq.br/7204169771610580 Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Campos, Rejane de Souza Macêdo [UNIFESP] |
dc.subject.por.fl_str_mv |
Falciform anemia Cerebral vascular reactivity Migraine Transcranial doppler Breath-holdin Doença falciforme Vasorreatividade cerebral Migranea Doppler transcraniano Breath-holding |
topic |
Falciform anemia Cerebral vascular reactivity Migraine Transcranial doppler Breath-holdin Doença falciforme Vasorreatividade cerebral Migranea Doppler transcraniano Breath-holding |
description |
Objectives: The purposes of this study were: to evaluate cerebral blood flow velocities and vasoreactivity using transcranial Doppler (TCD) in children with SCD and to compare them with healthy subjects; to compare cerebral blood flow velocities and vasoreactivity with TCD in children with SCD, with and without migraine, and healthy subjects; to determine headache and migraine frequencies in children with SCD. Methods: Children aged 10 to 18 years old with SCD were evaluated from the hemoglobinopathy clinics at UNIFESP. Healthy children of similar age and gender were included. A structured questionnaire was applied to all patients evaluating the presence of headache, its frequency and if migraine criteria were fulfilled. Demographic characteristics, comorbidities, medication use, laboratory and imaging exams data were collected from medical records. TCD was performed in all patients and controls subjects, with breath-holding maneuver and calculation of the breathholding index (BHI) to assess cerebral vasoreactivity. Cerebral blood flow velocities were assessed in both middle, anterior, posterior, vertebrals and basilar arteries. Cerebral blood flow velocities and vasorreactivity were compared between patients and control subjects and also between patients with SCD with and without migraine and healthy controls. Statistical analyses were performed using SPSS 18.0. Results: TCD was performed in 42 patients, mean age 12,67?2,18 years, and 20 controls subjects, mean age 13,90?3,04 years. Blood flow velocities were higher in patients with SCD than health volunteers in all arteries evaluated. Cerebral blood flow velocities were negatively correlated with hemoglobin levels (p<0,05). BHI was abnormal in 19% of the patients and in none of the controls (p=0.04). BHI values in patients were significantly lower than in control subjects (p<0.01 at right and p=0.01 at left). There were no differences in blood flow velocities between patients with or without migraine. BHI was similar in children with SCD with or without migraine, and between both and control subjects. A total of 57,1% had headache and 38% fulfilled criteria for migraine Conclusions: Cerebral vasoreactivity may be impaired in children with SCD, with BHI significantly lower in this group, maybe reflecting a low vascular reserve and autoregulation capacity in these patients. Cerebral vasoreactivity was not different between patients with or without migraine and both and controls subjects. Migraine was found in more than one third of our patients. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-10-25 2018-07-27T15:50:53Z 2018-07-27T15:50:53Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4318245 CAMPOS, Rejane de Souza Macêdo. Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano. 2016. 80 f. Dissertação (Mestrado em Neurologia - Neurociências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016. Rejane de Souza Macêdo Campos - PDF A.pdf http://repositorio.unifesp.br/handle/11600/46806 |
url |
https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=4318245 http://repositorio.unifesp.br/handle/11600/46806 |
identifier_str_mv |
CAMPOS, Rejane de Souza Macêdo. Estudo da vasorreatividade cerebral em crianças com doença falciforme: avaliação pelo doppler transcraniano. 2016. 80 f. Dissertação (Mestrado em Neurologia - Neurociências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2016. Rejane de Souza Macêdo Campos - PDF A.pdf |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
80 f. application/pdf |
dc.coverage.none.fl_str_mv |
São Paulo |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268325147967488 |