RESUMO
BACKGROUND: Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. OBJECTIVE: The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics. METHODS: This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age. RESULTS: Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger. CONCLUSION: Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.
RESUMO
Introduction: Chronic extrahepatic non-tumoral thrombotic portal vein occlusion in non-cirrhotic patients is a rare condition, affecting 5-10% of patients with portal hypertension. Presentation of case: The present study reports the case of a young patient without previous comorbidities who presented with portal hypertension secondary to chronic extrahepatic non-tumoral thrombotic occlusion of the portal vein. He underwent portal recanalization with a 12 × 80 mm nitinol self-expandable stent and embolization of esophagogastric varices with fibrous springs and cyanoacrylate via transparieto-hepatic access. Immediate resolution of the trans-lesion pressure gradient was obtained transoperatively, while complete remission of esophagogastric varices was verified by endoscopic control during outpatient follow-up. Discussion: Chronic portal vein occlusion is associated or not with liver cirrhosis. The chronic phase is characterized by cavernomatous transformation of the portal vein, which consists of the formation of multiple collaterals that bypass the lesion. This phase usually courses with portal hypertension and consequent variceal gastrointestinal bleeding. Decompression of the portal system through direct recanalization (angioplasty with stenting) is one therapeutic options. Conclusion: We conclude that, in the present case, resolving portal hypertension by direct portal recanalization was a good therapeutic option, as it decompressed the portal system while maintaining the hepatopetal flow.