OBJECTIVE: CLOVES syndrome (CLO: congenital lipomatous overgrowth, V: vascular anomalies E: epidermal nevi S: spinal anomalies) is a rare, non-heritable sporadic overgrowth disorder with serious morbidity. Previous anecdotal reports indicate that CLOVES patients are at risk for serious thromboembolic events in the perioperative period. The purpose of this study is to systematically determine the adverse events associated with anesthesia and diagnostic or interventional procedures for CLOVES patients, so appropriate assessment of risk can be performed and adequate precautions can be taken in the future to prevent complications. METHODS: We selected our study cohort by gathering patients in the Vascular Anomalies Center (VAC) database with the diagnosis of CLOVES syndrome. Our primary group of interest was patients that were anesthetized at Boston Children's Hospital (BCH) since 2005. All patients having the diagnosis of CLOVES were included. IRB approval was obtained prior to patient selection. Data was collected from BCH electronic medical records. Patient age, gender, ASA level, estimated amount of blood loss (EBL), surgery status, MRI status, complication(s), type of complication if any, and medical history was recorded in a Microsoft Excel document on a password-protected computer. Data analysis was carried out with no statistical analysis beyond simple incidence and prevalence of certain characteristics due to the extremely small patient population. RESULTS: We found that out of the 38 patients in our cohort, 15 (or 39%) suffered from complications during the perioperative period. A total of 23 (or 61%) did not have any complications. Results further showed that pulmonary emboli, respiratory issues, and hypo/hypertension were the most prevalent complications. In addition we found that there was no correlation between substantial EBL and complication occurrence in this cohort. CONCLUSION: In comparison to preliminary studies of Alomari, 2008 and Sapp et al., 2007, we report a lower occurrence of thromboembolic events in CLOVES patients. We hypothesize that this is because patients at BCH were treated aggressively with various prophylactic methods to help minimize the risk of such events. We recommend that early prophylactic anticoagulation methods are applied to future patients. Additionally, we recommend that CLOVES patients be followed by a hematologist and care team that are familiar with the condition throughout their stay at the hospital to reduce the risk of thromboembolic events.

Made available in DSpace on 2016-08-19T12:56:35Z (GMT). No. of bitstreams: 1 WALERIA_ FERREIRA_ RABELO.pdf: 1414450 bytes, checksum: a5589c3f85166730ef18134e4d347fde (MD5) Previous issue date: 2010-09-24 / The vegetable specie Syzygium aromaticum, known as clove is a 12 to 15 meters high tree that belongs the Mirtaceae family. In Brazil, the plants are found in warm regions, especially at the lower southern region of the state of Bahia. Their floral bud contains an essential oil of high economical value in the international market, due to the high content of eugenol (its main compound) which is widely used in the chemical and pharmaceutical industries. In this work the extraction of essential oil from dried flower buds of cloves by the hydrodistillation method, using a Clevenger s system. Was observed that the maximum volume of oil is extracted in a time of 4 hours with a 3,54 % m/m yield. Besides the physical-chemical parameters as density, refraction rate, solubility, color and appearance, was possible- the techniques of gas chromatography and mass spectrometry identify with security the eugenol as majority constituent of the essential oil of Syzygium aromaticum. The method of normalization was possible to identify and quantify the components: eugenol (52.53 %), caryophyllene (37.25 %), humulene (4.11 %), eugenol acetate (4.05 %) and copaene (2.05 %). With the application of the essential oil of clove and eugenol in the standard bioassay of toxicity observed a high toxic potential against the larvae of Artemia salina. It was also still evaluated the essential oil s antibacterial activity of the essential oil and eugenol standard over the bacteria Escherichia coli, Pseudomonas aeruginosa and Salmonella ssp, isolated from food and water. The study microbiological showed that the essential oil of cloves presented a good antibacterial activity against the strains tested, being eugenol the main responsible for this efficiency. / A espécie vegetal do Syzygium aromaticum, conhecida popularmente como Cravo da Índia, é uma árvore de 12 a 15 m de altura, que pertence à família das Mirtaceae. No Brasil, a planta é encontrada em regiões quentes, principalmente na região do baixo sul da Bahia. Seus botões florais contêm um óleo essencial de grande valor econômico no mercado internacional, devido ao elevado teor de eugenol (seu composto majoritário) o qual é largamente usado nas indústrias químicas e farmacêuticas. Neste trabalho, realizou-se a extração do óleo essencial dos botões florais secos do cravo da índia pelo método da hidrodestilação, utilizando um sistema de Clevenger. Observou-se que o volume máximo de óleo é extraído em um tempo de 4 horas com um rendimento de 3,54 % m/m. Além dos parâmetros físico-químicos como a densidade, índice de refração, solubilidade, cor e aparência; foi possível pela técnica da cromatografia gasosa acoplada a espectrometria de massas identificar com segurança o eugenol como constituinte majoritário do óleo essencial do Syzygium aromaticum. Pelo método da normalização foi possível identificar e quantificar os componentes: eugenol (52,53 %), cariofileno (37,25 %), humuleno (4,11 %), acetato de eugenila (4,05 %) e copaeno (2,05 %). Com a aplicação do óleo essencial do cravo e do padrão de eugenol no bioensaio com a toxicidade observou-se um grande potencial tóxico frente às larvas da Artemia salina. Avaliou-se ainda a atividade antibacteriana do óleo essencial e do padrão de eugenol sobre as bactérias Escherichia coli, Pseudomonas aeruginosa, Salmonella ssp, isoladas de alimentos e água. O estudo microbiológico revelou que o óleo essencial do cravo da índia apresentou uma boa atividade antibacteriana contra as cepas testadas, sendo que o eugenol é o principal responsável por essa eficácia.