<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282021000200128</article-id>
<article-id pub-id-type="doi">10.29315/gm.v8i2.403</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Síndrome da Veia Cava Superior: Um desafio para o Internista de um Hospital Distrital]]></article-title>
<article-title xml:lang="en"><![CDATA[Superior Vena Cava Syndrome: A Challenge for an Internist in a Peripheral Hospital]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaudêncio]]></surname>
<given-names><![CDATA[Margarida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Faria]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Baptista]]></surname>
<given-names><![CDATA[Filipa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[Patrícia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bessa]]></surname>
<given-names><![CDATA[Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[Amélia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>8</volume>
<numero>2</numero>
<fpage>128</fpage>
<lpage>135</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282021000200128&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282021000200128&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282021000200128&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A síndrome da veia cava superior surge quando existe uma diminuição ou obstrução do fluxo venoso da cabeça, pescoço e membros superiores através da veia cava superior por trombose ou compressão extrínseca da mesma. Pode ter diversas etiologias, sendo a causa neoplásica uma das mais frequentes, constituindo uma urgência oncológica. Numa abordagem inicial, o uso de corticoterapia e diuréticos endovenosos, combinado com a elevação da cabeceira são medidas fundamentais. Para além disso, o tratamento da doença de base, radioterapia de urgência e radiologia de intervenção são as opções mais viáveis. Os autores propõem-se apresentar uma série de casos que surgiram no serviço de urgência de um hospital distrital durante o período de um ano. Dois casos surgiram em doentes com neoplasias já conhecidas e em tratamento, sendo as neoplasias em questão - linfoma MALT brônquico e carcinoma papilar da tiroide com metastização pulmonar e mediastínica. Outro dos doentes tinha uma formação nodular a nível do lobo superior direito do pulmão, sem identificação histológica. No outro caso, esta síndrome foi a apresentação inicial, tendo os exames complementares demonstrado a presença de massa mediastínica, biopsada através de mediastinoscopia, que revelou linfoma difuso de grandes células B. Os doentes apresentavam idades compreendidas entre os 61 e 81 anos. Para todos, foi pedido apoio ao hospital de referência pela inexistência de radiologia de intervenção e radioterapia no nosso hospital. A síndrome da veia cava superior pode apresentar várias etiologias, tendo os casos descritos ocorrido em contexto de doença oncológica. Esta série de casos alerta-nos para o desafio clínico e sobretudo terapêutico num hospital distrital, assim como, reforça a importância de equipa multidisciplinar e inter-hospitalar para a melhor orientação dos doentes, procurando oferecer as melhores alternativas terapêuticas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Superior vena cava syndrome results from decrease or obstruction in the venous flow of the head, neck and upper limbs due to thrombosis or extrinsic compression of the vena cava. It can have different etiologies, the neoplastic cause being one of the most frequent, constituting an oncological urgency. In an initial approach, the use of corticosteroid therapy and intravenous diuretics, combined with the elevation of the headboard are fundamental measures. In addition, treatment of the underlying disease, emergency radiotherapy and intervention radiology are the most relevant options. The authors propose to present a series of cases that emerged in the emergency department of a district hospital during the period of one year. Two cases appeared in patients with already known neoplasia (bronchial MALT lymphoma and papillary thyroid carcinoma with pulmonary and mediastinal metastasis) and under treatment. Another patient had a nodular formation at the level of the right upper lung lobe, without histological identification. In the other case, this syndrome was the initial presentation, with complementary exams showing the presence of a mediastinal mass, biopsied through mediastinoscopy, which revealed diffuse large B-cell lymphoma. The patients were aged between 61 and 81 years old. For all, support was requested from a central hospital for the lack of intervention radiology and radiotherapy in our hospital. Superior vena cava syndrome can have several etiologies, with the cases described occurring in the context of oncological disease. This series of cases alerts us to the clinical and, above all, therapeutic challenge in a district hospital, as well as reinforcing the importance of a multidisciplinary and inter-hospital team to better orient patients, seeking to offer the best therapeutic alternatives.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Síndrome da Veia Cava Superior/diagnóstico]]></kwd>
<kwd lng="pt"><![CDATA[Síndrome da Veia Cava Superior/etiologia]]></kwd>
<kwd lng="en"><![CDATA[Superior Vena Cava Syndrome/diagnosis]]></kwd>
<kwd lng="en"><![CDATA[Superior Vena Cava Syndrome/etiology]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[K Khan]]></surname>
<given-names><![CDATA[UA]]></given-names>
</name>
<name>
<surname><![CDATA[Shanholtz]]></surname>
<given-names><![CDATA[CB]]></given-names>
</name>
<name>
<surname><![CDATA[McCurdy]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oncologic Mechanical Emergencies]]></article-title>
<source><![CDATA[Hematol Oncol Clin North Am]]></source>
<year>2017</year>
<volume>31</volume>
<page-range>927-40</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rachapalli]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Boucher]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Superior vena cava syndrome: role of the interventionalist]]></article-title>
<source><![CDATA[Can Assoc Radiol J]]></source>
<year>2014</year>
<volume>65</volume>
<page-range>168-76</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kalra]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sen]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Gloviczki]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endovenous and Operative Treatment of Superior Vena Cava Syndrome]]></article-title>
<source><![CDATA[Surg Clin North Am]]></source>
<year>2018</year>
<volume>98</volume>
<page-range>321-35</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mena]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Carbajal-Mendoza]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Matos]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Karki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Superior vena cava syndrome: A medical emergency?]]></article-title>
<source><![CDATA[Int J Angiol]]></source>
<year>2008</year>
<volume>17</volume>
<page-range>43-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zimmerman]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rapid Fire: Superior Vena Cava Syndrome]]></article-title>
<source><![CDATA[Emerg Med Clin North Am]]></source>
<year>2018</year>
<volume>36</volume>
<page-range>577-84</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Grateau]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Reuter]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[de Kerviler]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[de Margerie-Mellon]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[de Bazelaire]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of superior vena cava syndrome in critically ill cancer patients]]></article-title>
<source><![CDATA[Support Care Cancer]]></source>
<year>2018</year>
<volume>26</volume>
<page-range>521-8</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[R Ratzon]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tamir]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Friehmann]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Livneh]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Dudnik]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Rozental]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thrombosis, anticoagulation and outcomes in malignant superior vena cava syndrome]]></article-title>
<source><![CDATA[J Thromb Thrombolysis]]></source>
<year>2019</year>
<volume>47</volume>
<page-range>121-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Deshwal]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ghosh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Magruder]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Bartholomew]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Montgomery]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mehta]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A review of endovascular stenting for superior vena cava syndrome in fibrosing mediastinitis]]></article-title>
<source><![CDATA[Vasc Med]]></source>
<year>2020</year>
<volume>25</volume>
<page-range>174-83</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[CI]]></given-names>
</name>
<name>
<surname><![CDATA[Njo]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
<name>
<surname><![CDATA[Karim]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypofractionated radiation therapy in the treatment of superior vena cava syndrome]]></article-title>
<source><![CDATA[Lung Cancer]]></source>
<year>1993</year>
<volume>10</volume>
<page-range>221-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Urban]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Lebeau]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Chastang]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Leclerc]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Botto]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Sauvaget]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Superior vena cava syndrome in small-cell lung cancer]]></article-title>
<source><![CDATA[Arch Intern Med]]></source>
<year>1993</year>
<volume>153</volume>
<page-range>384-7</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yim]]></surname>
<given-names><![CDATA[CD]]></given-names>
</name>
<name>
<surname><![CDATA[Sane]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Bjarnason]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Superior vena cava stenting]]></article-title>
<source><![CDATA[Radiol Clin North Am]]></source>
<year>2000</year>
<volume>38</volume>
<page-range>409-24</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Young]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Yeghiaian-Alvandi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Chin]]></surname>
<given-names><![CDATA[YS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Use of endovascular metal stents to alleviate malignant superior vena cava syndrome]]></article-title>
<source><![CDATA[Intern Med J]]></source>
<year>2003</year>
<volume>33</volume>
<page-range>542-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
