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Sample records for chronic venous stasis

  1. Duration of increase in vascular volume during venous stasis

    DEFF Research Database (Denmark)

    Sejrsen, P; Henriksen, O; Paaske, W P;

    1981-01-01

    Duration of increase in vascular volume in the crus following application of venous stasis was studied in 3 healthy subjects placed in a supine position. Changes in calf volume during venous stasis was measured by plethysmography. In one series of experiments changes in vascular volume were studied...... by measurements of accumulation of 133Xenon proximal to a depot located in the anterior tibial muscle. In another series of experiments changes in activity of 99mTc-labelled erythrocytes were used as indicator for changes in vascular volume. Following application of venous stasis in the horizontal...... position the rate of increase in calf volume declined to a steady level after about 5 min. Both the studies with 133Xenon and with 99mTc-erythrocytes indicate that vascular volume continued to increase for 3, 3.5 and 5 min following venous stasis of 20, 30 and 40 mmHg, respectively. When the crus was...

  2. Phleboscintigraphic detection of incompetent perforating veins to guide the surgical treatment of venous stasis ulceration

    International Nuclear Information System (INIS)

    Most venous leg ulcers are due to the incompetence of perforating veins. The principal aim of surgery in the treatment of chronic ulcers which are not responsive to conservative therapy, is the identification, division and ligation of those incompetent perforating veins which transmit the hig venous pressure to the ulcerated area. Both radionuclide scanning and contrast venography may be accurate methods of evaluating the deep venous system and incompetent perforating veins; however, the role of radionuclide scanning in this setting is not fully exploited. The authors present one case of chronic, refractory postphlebitic ulcer in which radionuclide venography was employed to detect the incompetent perforating vein responsible for the development of the ulcer. Radionuclide venography (with Tc-99m red blood cells) allowed the main perforating vein to be clearly detected among others already identified by contrast venography. After surgical treatment the ulcer healed, and the perforating vein had disappeared when venoscintigraphy was repeated. In the author's opinion radionuclide venography is a useful support to contrast venography in planning the surgical treatment of venous stasis ulcers. (orig.)

  3. Improvement of wound healing by water-filtered infrared-A (wIRA in patients with chronic venous stasis ulcers of the lower legs including evaluation using infrared thermography

    Directory of Open Access Journals (Sweden)

    Hoffmann, Gerd

    2008-10-01

    Full Text Available Background: Water-filtered infrared-A (wIRA is a special form of heat radiation with a high tissue-penetration and with a low thermal burden to the surface of the skin. wIRA is able to improve essential and energetically meaningful factors of wound healing by thermal and non-thermal effects. Aim of the study: prospective study (primarily planned randomised, controlled, blinded, de facto with one exception only one cohort possible using wIRA in the treatment of patients with recalcitrant chronic venous stasis ulcers of the lower legs with thermographic follow-up. Methods: 10 patients (5 males, 5 females, median age 62 years with 11 recalcitrant chronic venous stasis ulcers of the lower legs were treated with water-filtered infrared-A and visible light irradiation (wIRA(+VIS, Hydrosun® radiator type 501, 10 mm water cuvette, water-filtered spectrum 550–1400 nm or visible light irradiation (VIS; only possible in one patient. The uncovered wounds of the patients were irradiated two to five times per week for 30 minutes at a standard distance of 25 cm (approximately 140 mW/cm2 wIRA and approximately 45 mW/cm2 VIS. Treatment continued for a period of up to 2 months (typically until closure or nearly closure of the ulcer. The main variable of interest was “percent change of ulcer size over time” including complete wound closure. Additional variables of interest were thermographic image analysis, patient’s feeling of pain in the wound, amount of pain medication, assessment of the effect of the irradiation (by patient and by clinical investigator, assessment of feeling of the wound area (by patient, assessment of wound healing (by clinical investigator and assessment of the cosmetic state (by patient and by clinical investigator. For these assessments visual analogue scales (VAS were used. Results: The study showed a complete or nearly complete healing of lower leg ulcers in 7 patients and a clear reduction of ulcer size in another 2 of 10

  4. Stasis Dermatitis

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Stasis dermatitis Overview Severe stasis dermatitis on the lower leg ... blood flow leads to these skin changes. Stasis dermatitis: Overview Also called gravitational dermatitis, venous eczema, and ...

  5. Assessment of microcirculation of the skin using Tissue Viability Imaging: A promising technique for detecting venous stasis in the skin

    OpenAIRE

    Bergkvist, Max; Henricson, Joakim; Iredahl, Fredrik; Tesselaar, Erik; Sjöberg, Folke; Farnebo, Simon

    2015-01-01

    Background: : Venous occlusion in the skin is difficult to detect by existing measurement techniques. Our aim was to find out whether Tissue Viability Imaging (TiVi) was better at detecting venous occlusion by comparing it with results of laser Doppler flowmetry (LDF) during graded arterial and venous stasis in human forearm skin. Methods: : Arterial and venous occlusions were simulated in 10 healthy volunteers by inflating a blood pressure cuff around the upper right arm. Changes in the conc...

  6. Chronic Venous Disease under pressure

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan)

    2013-01-01

    textabstractIn chapter 1 we provide a general introduction of this thesis. Chronic venous disease (CVD) is a common medical condition that affects 2-64% of the worldwide population and leads to leg ulcers in 1% of the Western population. Venous leg ulceration (VLU) has an unfavorable prognosis with

  7. Treatment of Chronic Venous Insufficiency

    OpenAIRE

    KÖKSAL, Cengiz; Alsalehi, Saleh; Kocamaz, Özgür; Sunar, Hasan

    2009-01-01

    Chronic venous insufficiency (CVI), with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The diagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral v...

  8. Treatment of Chronic Venous Insufficiency

    OpenAIRE

    Cengiz Köksal; Saleh Alsalehi; Özgür Kocamaz; Hasan Sunar

    2010-01-01

    Chronic venous insufficiency (CVI), with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The iagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral ve...

  9. RheoStim: Development of an Adaptive Multi-Sensor to Prevent Venous Stasis

    OpenAIRE

    Weyer, Sören; Weishaupt, Fabio; Kleeberg, Christian; Leonhardt, Steffen; Teichmann, Daniel

    2016-01-01

    Chronic venous insufficiency of the lower limbs is often underestimated and, in the absence of therapy, results in increasingly severe complications, including therapy-resistant tissue defects. Therefore, early diagnosis and adequate therapy is of particular importance. External counter pulsation (ECP) therapy is a method used to assist the venous system. The main principle of ECP is to squeeze the inner leg vessels by muscle contractions, which are evoked by functional electrical stimulation...

  10. Treatment of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Cengiz Köksal

    2010-08-01

    Full Text Available Chronic venous insufficiency (CVI, with its high prevalence, high cost of diagnosis and treatment, substantial loss in manpower and negative effects on quality of life, is an important health issue. A comprehensive knowledge of the anatomy and functions of venous system is a must to understand the pathophysiology of CVI. The iagnosis of CVI is made by history, physical examination and noninvasive tests. The traditional surgical strategy for CVI treatment is high ligation of saphenofemoral vein and saphenous vein stripping. In recent years, novel minimally invasive techniques such as ultrasound-guided foam sclerotherapy, endovenous laser and radiofrequency ablation have been more widely applied. Here, we have reviewed the various treatment strategies used in CVI.

  11. RheoStim: Development of an Adaptive Multi-Sensor to Prevent Venous Stasis.

    Science.gov (United States)

    Weyer, Sören; Weishaupt, Fabio; Kleeberg, Christian; Leonhardt, Steffen; Teichmann, Daniel

    2016-01-01

    Chronic venous insufficiency of the lower limbs is often underestimated and, in the absence of therapy, results in increasingly severe complications, including therapy-resistant tissue defects. Therefore, early diagnosis and adequate therapy is of particular importance. External counter pulsation (ECP) therapy is a method used to assist the venous system. The main principle of ECP is to squeeze the inner leg vessels by muscle contractions, which are evoked by functional electrical stimulation. A new adaptive trigger method is proposed, which improves and supplements the current therapeutic options by means of pulse synchronous electro-stimulation of the muscle pump. For this purpose, blood flow is determined by multi-sensor plethysmography. The hardware design and signal processing of this novel multi-sensor plethysmography device are introduced. The merged signal is used to determine the phase of the cardiac cycle, to ensure stimulation of the muscle pump during the filling phase of the heart. The pulse detection of the system is validated against a gold standard and provides a sensitivity of 98% and a false-negative rate of 2% after physical exertion. Furthermore, flow enhancement of the system has been validated by duplex ultrasonography. The results show a highly increased blood flow in the popliteal vein at the knee. PMID:27023544

  12. RheoStim: Development of an Adaptive Multi-Sensor to Prevent Venous Stasis

    Directory of Open Access Journals (Sweden)

    Sören Weyer

    2016-03-01

    Full Text Available Chronic venous insufficiency of the lower limbs is often underestimated and, in the absence of therapy, results in increasingly severe complications, including therapy-resistant tissue defects. Therefore, early diagnosis and adequate therapy is of particular importance. External counter pulsation (ECP therapy is a method used to assist the venous system. The main principle of ECP is to squeeze the inner leg vessels by muscle contractions, which are evoked by functional electrical stimulation. A new adaptive trigger method is proposed, which improves and supplements the current therapeutic options by means of pulse synchronous electro-stimulation of the muscle pump. For this purpose, blood flow is determined by multi-sensor plethysmography. The hardware design and signal processing of this novel multi-sensor plethysmography device are introduced. The merged signal is used to determine the phase of the cardiac cycle, to ensure stimulation of the muscle pump during the filling phase of the heart. The pulse detection of the system is validated against a gold standard and provides a sensitivity of 98% and a false-negative rate of 2% after physical exertion. Furthermore, flow enhancement of the system has been validated by duplex ultrasonography. The results show a highly increased blood flow in the popliteal vein at the knee.

  13. Chronic cerebrospinal venous insufficiency and venous stenoses in multiple sclerosis

    DEFF Research Database (Denmark)

    Blinkenberg, M; Akeson, P; Sillesen, H;

    2012-01-01

    The traditional view that multiple sclerosis (MS) is an autoimmune disease has recently been challenged by the claim that MS is caused by chronic cerebrospinal venous insufficiency (CCSVI). Although several studies have questioned this vascular theory, the CCSVI controversy is still ongoing. Our...

  14. The controversy on chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2013-08-01

    Full Text Available The objective of this review is to analyze the actual scientific controversy on chronic cerebrospinal venous insufficiency (CCSVI and its association with both neurodegenerative disorders and multiple sclerosis (MS. We revised all published studies on prevalence of CCSVI in MS patients, including ultrasound and catheter venography series. Furthermore, we take into consideration other publications dealing with the pathophysiologic consequences of CCSVI in the brain, as well as ecent data characterizing the pathology of the venous wall in course of CCSVI. Finally, safety and pilot data on effectiveness of endovascular CCSVI treatment were further updated. Studies of prevalence show a big variability in prevalence of CCSVI in MS patients assessed by established ultrasonographic criteria. This could be related to high operator dependency of ultrasound. However, 12 studies, by the means of more objective catheter venography, show a prevalence >90% of CCSVI in MS. Global hypo-hypoperfusion of the brain, and reduced cerebral spinal fluid dynamics in MS was shown to be related to CCSVI. Postmortem studies and histology corroborate the 2009 International Union of Phlebology (UIP Consensus decision to insert CCSVI among venous malformations. Finally, safety of balloon angioplasty of the extracranial veins was certainly demonstrated, while prospective data on the potential effectiveness of endovascular treatment of CCSVI support to increase the level of evidence by proceeding with a randomized control trial (RCT. Taking into account the current epidemiological data, including studies on catheter venography, the autoptic findings, and the relationship between CCSVI and both hypo-perfusion and cerebro-spinal fluid flow, we conclude that CCSVI can be definitively inserted among the medical entities. Research is still inconclusive in elucidating the CCSVI role in the pathogenesis of neurological disorders. The controversy between the vascular and the

  15. Chronic cerebrospinal venous insufficiency: current perspectives

    Directory of Open Access Journals (Sweden)

    Simka M

    2014-03-01

    Full Text Available Marian Simka Department of Nursing, College of Applied Sciences, Ruda Slaska, Poland Abstract: This review summarizes the research to date on chronic cerebrospinal venous insufficiency (CCSVI. CCSVI was initially defined as a clinical syndrome comprising stenoses of the internal jugular and/or azygos veins, characterized by collateral venous outflows and reduced cerebral blood flow, and was found primarily in patients with multiple sclerosis. However, the published evidence on CCSVI is very discordant. Catheter venography studies gave a regular picture, with the majority of patients with multiple sclerosis presenting with demonstrable outflow abnormalities in the veins draining the central nervous system. The prevalence of these lesions was over 50%, and even higher (about 90% when more liberal definition of an abnormality or intravascular sonography was used. Further, the results of magnetic resonance venography studies have been quite consistent, in that stenoses of the internal jugular veins have been found in 25%–70% of patients with multiple sclerosis. In contrast, Doppler sonography studies have revealed CCSVI in 0% to 100% of patients. The research is currently suggesting that CCSVI is not a single entity, but rather a group of different anatomic and functional venous abnormalities. Regarding venous outflow from the brain, a patient can present either with diminished inflow to the internal jugular veins resulting from decreased cerebral circulation or with externally compressed or hypoplastic internal jugular veins or stenotic jugular valves. Considering these many faces of CCSVI, it becomes more comprehensible as to why the results of the studies, especially those utilizing Doppler sonography, have been so discordant. Not only were investigators using different diagnostic modalities and distinct protocols, but they were not looking for the same pathology. Since these abnormalities were indeed differently prevalent in patients and

  16. Iliocaval Confluence Stenting for Chronic Venous Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  17. Improvements of Venous Tone with Pycnogenol in Chronic Venous Insufficiency: An Ex Vivo Study on Venous Segments

    OpenAIRE

    Belcaro, Gianni; Dugall, Mark; Luzzi, Roberta; Hosoi, M.; Corsi, Marcello

    2014-01-01

    This study evaluated the stretching and dilatation of venous segments ex vivo in subjects with primary varicose veins in comparison with comparable segments from subjects that used the supplement Pycnogenol (150 mg/d) for 3 months before surgery. Subjects with varicose veins and chronic venous insufficiency voluntarily used Pycnogenol for a period of at least 3 months. The segments of veins removed with surgery (in 30 subjects that had used Pycnogenol and in 10 comparable control subjects tha...

  18. An Experimental Study on Drugs for Improving Blood Circulation and Removing Blood Stasis in Treating Mild Chronic Hepatic Damage

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Large and small doses of drugs for improving blood circulation and removing blood stasis were used in model rats to treat mild chronic hepatic damage induced by carbon tetrachloride (CCl4). The results show that large dose of Dang Gui (当归 Radix Angelicae Sinensis) and Dan Shen (丹参 Radix Salviae Miltiorrhizae) (drugs for regulating blood flow) and small dose of Yu Jin (郁金 Radix Curcumae) and Niu Xi (牛膝 Radix Achyranthis Bidentatae) (drugs for activating blood flow) can significantly elevate the activity of SOD (P<0.05) and/or lower the T/K ratio, markedly reduce the MDA content (P<0.05 or P<0.01) and significantly decrease the activities of ALT and AST (P<0.05 or P<0.01), demonstrating that these drugs are effective in combating oxygen free radicals (OFR) in chronic liver damage. On the contrary, large dose of Tu Bie Chong (土鳖虫 Eupolyphaga seu Steleophaga) and E Zhu (莪术 Rhizoma Curcumae) (drugs for removing blood stasis) tend to increase the ALT and AST (P<0.05) activities. The results suggest that the synergism of elevation of the SOD activity and reduction of T/K ratio contributes to the action of drugs for improving blood circulation and removing blood stasis in combating the liver damage induced by CCl4.

  19. Case 3: chronic venous leg ulcer.

    Science.gov (United States)

    Hämmerle, Gilbert

    2016-03-01

    A non-healing, sloughy venous leg ulcer quickly responded to topical treatment including octenilin Wound Gel and octenilin Wound Irrigation Solution. Full healing occurred within 6 weeks. PMID:26949848

  20. Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers*

    Science.gov (United States)

    Januário, Virginia; de Ávila, Dione Augusto; Penetra, Maria Alice; Sampaio, Ana Luisa Bittencourt; Noronha Neta, Maria Isabel; Cassia, Flavia de Freire; Carneiro, Sueli

    2016-01-01

    BACKGROUND: Among the chronic leg ulcers, venous ulcers are the most common and constitute a major burden to public health. Despite all technology available, some patients do not respond to established treatments. In our study, carboxymethylcellulose was tested in the treatment of refractory chronic venous ulcers. OBJECTIVE: To evaluate the efficacy of carboxymethylcellulose 20% on the healing of chronic venous ulcers refractory to conventional treatments. METHODS: This is an analytical, pre-experimental study. Thirty patients were included with refractory venous ulcers, and applied dressings with carboxymethylcellulose 20% for 20 weeks. The analysis was based on measurement of the area of ulcers, performed at the first visit and after the end of the treatment. RESULTS: There was a reduction of 3.9 cm2 of lesion area (p=0.0001), corresponding to 38.8% (p=0.0001). There was no interruption of treatment and no increase in lesion area in any patient. CONCLUSIONS: Carboxymethylcellulose 20% represents a low cost and effective therapeutic alternative for the treatment of refractory chronic venous ulcers. However, controlled studies are necessary to prove its efficacy. PMID:26982773

  1. Pycnogenol® in chronic venous insufficiency and related venous disorders.

    Science.gov (United States)

    Gulati, Om P

    2014-03-01

    The present review provides an update of the biological profile of Pycnogenol in the light of its use in the treatment of chronic venous insufficiency (CVI) and related venous disorders such as deep vein thrombosis (DVT), post-thrombotic syndrome, long haul air-travel-related leg oedema, venous ulcers and acute haemorrhoids. Pycnogenol is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. subsp. atlantica. Its strong antioxidant, anti-inflammatory and vasodilator activities, antithrombotic effects and collagen stabilizing properties make it uniquely able to target the multi facet pathophysiology of CVI and related venous disorders. Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long haul flights and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration. This review highlights clinical research findings on the safety, compliance and efficacy of Pycnogenol, including its use in combination products. PMID:23775628

  2. Urinary hemosiderin: role in evaluation of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Ashish Lal Shrestha

    2012-08-01

    Full Text Available Chronic venous insufficiency (CVI leads to skin changes with dermal hemosiderin deposition. We studied the presence of hemosiderin in the urine to assess if this could be used as a biochemical marker for CVI. Hereby we present a case control study conducted in a tertiary care centre in South India. There were 100 cases with evidence of advanced CVI (the Clinical-Etiology-Anatomy-Pathophysiology classification: C5, C6 confirmed by duplex scanning. Controls were 50 patients with leg ulcers due to other etiologies. All patients were subjected to urinary hemosiderin testing. In all 100 patients with CVI (C5 and C6 disease axial venous reflux was confirmed by duplex ultrasound. Superficial venous reflux was noted in 71% of patients and deep venous reflux in 54.%. Primary venous insufficiency was the etiology in 81% of patients. Only 4/100 patients had detectable amounts of hemosiderin in the urine. Urine hemosiderin testing to determine presence or absence of CVI yielded the following values: positive predictive value-80%; negative predictive value-33%; sensitivity-4% and specificity-98%. The test could not be recommended as a marker of CVI. In Indian patients urinary hemosiderin is not a useful screening test in CVI.

  3. Chronic portomesenteic venous thrombosis complicated by a high flow arteriovenous malformation presenting with gastrointestinal bleeding.

    Science.gov (United States)

    Plotnik, Adam N; Hebroni, Frank; McWilliams, Justin

    2016-02-01

    Portomesenteric venous thrombosis is a rare but potentially life-threatening condition. The presenting symptoms of chronic portomesenteric venous thrombosis are often non-specific but may present with variceal bleeding. We present the first reported case of chronic portomesenteric venous thrombosis causing a high flow arteriovenous malformation that resulted in extensive gastrointestinal bleeding. PMID:25871943

  4. 'Chronic cerebrospinal venous insufficiency' in multiple sclerosis. Is multiple sclerosis a disease of the cerebrospinal venous outflow system?

    International Nuclear Information System (INIS)

    Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency (CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients. (orig.)

  5. Studies on venous chronic obstructions with perfused krypton-81m

    International Nuclear Information System (INIS)

    A perfusion system is used to study the venous return of the lower limbs through an injection of a superficial vein of the foot. Multiple sequential perfusions are possible because there is no building up of the radioactivity (short-life of the Kr-81m and lung elimination). We are therefore able to study the system under different mechanical conditions (tourniquet at different sites and pressures, hyperaemia). The main veins (from popliteal vein to vena cava) are therefore normally vizualised by a peripheral injection. The region below the knee is difficult to study by venoscintigraphy. The transit times from the foot to the groin, and between regions of interest are also studied. We analyse the results obtained with a consecutive serie of 31 patients suffering from possible chronic venous problems and sequelae of deep venous thrombosis (lasting for 2 weeks to more than 20 years): 58 limbs are actually examined. Most of these limbs are also assessed by non invasive heamodynamic techniques: Doppler ultrasound and calf plethysmography: 35 limbs are normal, 23 show obliterative sequelae of deep vein thrombosis. The venoscintigraphy displays the level and the degree of obstructions and the pattern of collateral pathways with an accuracy comparable to RX-phlebography. We demonstrate that the Doppler is able to recognize most of the residual obstructions. The resistances to venous outflow measured by plethysmography are also generally increased. We are not able to demonstrate systematic and significant variations of the transit times in the different haemodynamic conditions. These parameters do not seem therefore adequate for functional assessment

  6. Chronic venous leg ulcers – role of topical zinc

    Directory of Open Access Journals (Sweden)

    Maher SF

    2015-06-01

    Full Text Available Sara F Maher Physical Therapy Program, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA Abstract: Topical zinc has been used in the treatment of wounds for over 3,000 years, and is reported to have antiseptic, astringent, anti-inflammatory, antimicrobial, and wound healing properties. Fourteen studies were identified and reviewed, to assess the efficacy of this treatment modality as either a bandage or skin protectant in the treatment of venous ulcers. The authors of three studies reported improved healing time or success rate in wounds treated with zinc-based products. However, the authors of one study attributed the faster healing rate mainly to the extra compression (that improved venous blood return, delivered by the non-elastic paste bandage, and not by the zinc oxide alone. The quality of evidence is fair, as 50% of the studies were conducted prior to 2000 and 50% of the studies utilized fewer than 45 patients randomized to two or more groups. Other treatments have been reported to be more cost-effective than zinc, including hydrocolloids, four-layer compression systems, and CircAid Thera-boots. Finally, zinc was reported to be less comfortable, less easy to use, and caused increased pain, in comparison to other products on the market. This literature review, therefore, demonstrated that current evidence is insufficient to determine the effectiveness of zinc-based products in the treatment of venous wounds. Future research is needed focusing on larger, high-quality trials with an emphasis on quality of life issues and cost-effectiveness of treatment. Keywords: chronic wounds, leg ulcers, venous insufficiency, topical zinc

  7. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    OpenAIRE

    Reekers, J A; Lee, M. J.; Belli, A. M.; Barkhof, F

    2011-01-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the “venous hemodynami...

  8. Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

    OpenAIRE

    Leonardo Corcos; Daniele Pontello; Tommaso Spina

    2015-01-01

    Ineffectiveness or discomfort from graduated elastic compression stockings (GES) in patients with chronic venous insufficiency (CVI) and/or varicose veins of the lower limbs (VVLL) can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI). The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R) a...

  9. Improvements of venous tone with pycnogenol in chronic venous insufficiency: an ex vivo study on venous segments.

    Science.gov (United States)

    Belcaro, Gianni; Dugall, Mark; Luzzi, Roberta; Hosoi, M; Corsi, Marcello

    2014-03-01

    This study evaluated the stretching and dilatation of venous segments ex vivo in subjects with primary varicose veins in comparison with comparable segments from subjects that used the supplement Pycnogenol (150 mg/d) for 3 months before surgery. Subjects with varicose veins and chronic venous insufficiency voluntarily used Pycnogenol for a period of at least 3 months. The segments of veins removed with surgery (in 30 subjects that had used Pycnogenol and in 10 comparable control subjects that had not used the supplement) were compared with normal, unused vein segments harvested for bypass grafting. The segments were suspended and a weight was attached to the distal part of the veins for 3 minutes and dilated with pressurized water. Digital images were recorded; the veins were measured before and after stretching to evaluate elongation. The manipulation of the vein segment was minimal. Tests were completed within 20 minutes after harvesting the veins. All segments were 4 cm long. The stretching test indicated a significantly higher level of passive elongation in control, varicose segments (2.29; 0.65 mm) in comparison with 1.39; 0.2 mm in vein segments from Pycnogenol-using patients. The dilation test showed an average higher dilation (2.19; 0.3 mm) in control varicose veins in comparison with varicose veins from Pycnogenol-using patients (1.32; 0.7 mm) (p Pycnogenol-using subjects (p Pycnogenol. Varicose segments had a more significant persistent dilatation and elongation in comparison with normal vein segments. Pycnogenol seems to decrease passive dilatation and stretching and gives vein walls a greater tonic recovery and elasticity that allows the vein to recover its original shape after dynamic stresses. PMID:24627617

  10. Effect of beta-aescin extract from Chinese buckeye seed on chronic venous insufficiency.

    Science.gov (United States)

    Yu, Zhihong; Su, Ping

    2013-06-01

    The aim of this study was to explore the mechanism of domestic beta-aescin treating chronic venous insufficiency through observing its actions on the isolated canine saphenous venous tension, venous pressure, venous return and lymphatic return. The isolated canine spiral saphenous venous tension test was performed to detect the activity of the beta-aescin. Furthermore, in the condition of constant canine femoral artery perfusion kept in the extracorporeal circulation, we measured the changes of the canine femoral artery pressure, femoral artery flow and the lymphatic return flow after intravenous injection of the agent. The results showed that when beta-aescin was administrated at the dose between 5.0 x 10(-5)-5.25 x 10(-4) mol/L, it increased obviously the contractile tension of the venous to norepinephrine in a dose-dependent manner. With canine femoral artery perfusion kept constant, beta-aescin, whose doses were 50 mg and 100 mg, reinforced intently the canine femoral venous tension accelerated the rise of the venous pressure. These finding suggested that domestic betabeta-aescin extracted from Chinese Buckeye Seed had an effect on chronic venous insufficiency by strengthening the venous tension, increasing the venous pressure and promoting venous return and lymphatic return. PMID:23875249

  11. CT and MRI of the calf in chronic venous insufficiency

    International Nuclear Information System (INIS)

    Sixty-two lower limbs in 29 women and six men with chronic venous insufficiency (CVI) of grade II and III were examined by CT and eight of these additionally with MRI. The changes were compared with the findings in 21 patients of similar age, but without veneous abnormalities. The most important findings were subcutaneous fibrosis with or without calcification, nonspecific infiltration of the extra-fascial spaces and degeneration of the Achilles'tendon. The simultaneous occurrence of these changes can be regarded as typical of advanced CVI. CT was somewhat superior to MRI; its use can be justified as part of post-therapeutic follow-up and for special problems. (orig.)

  12. Chronic Stress Facilitates the Development of Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Tao Dong

    2015-01-01

    Full Text Available The increasing pressure of modern social life intensifies the impact of stress on the development of cardiovascular diseases, which include deep venous thrombosis (DVT. Renal sympathetic denervation has been applied as one of the clinical approaches for the treatment of drug-resistant hypertension. In addition, the close relationship between oxidative stress and cardiovascular diseases has been well documented. The present study is designed to explore the mechanism by which the renal sympathetic nerve system and the oxidative stress affect the blood coagulation system in the development of DVT. Chronic foot shock model in rats was applied to mimic a state of physiological stress similar to humans. Our results showed that chronic foot shock procedure could promote DVT which may be through the activation of platelets aggregation. The aggravation of DVT and activation of platelets were alleviated by renal sympathetic denervation or antioxidant (Tempol treatment. Concurrently, the denervation treatment could also reduce the levels of circulating oxidation factors in rats. These results demonstrate that both the renal sympathetic nerve system and the oxidative stress contribute to the development of DVT in response to chronic stress, which may provide novel strategy for treatment of clinic DVT patients.

  13. Telemedical Wearable Sensing Platform for Management of Chronic Venous Disorder.

    Science.gov (United States)

    Li, Ruya; Nie, Baoqing; Zhai, Chengwei; Cao, Jennifer; Pan, Jian; Chi, Yung-Wei; Pan, Tingrui

    2016-07-01

    Enabled by emerging wearable sensors, telemedicine can potentially offer personalized medical services to long-term home care or remote clinics in the future, which can be particularly helpful in the management of chronic diseases. The wireless wearable pressure sensing system reported in this article provides an excellent example of such an innovation, whereby periodic or continuous monitoring of interface pressure can be obtained to guide routine compression therapy, the cornerstone of chronic venous disorder management. By applying a novel capacitive, iontronic sensing technology, a flexible, ultrathin, and highly sensitive pressure sensing array is seamlessly incorporated into compression garments for the monitoring of interface pressure. The linear pressure sensing array assesses pressure distribution along the limb in a real-time manner (up to a scanning rate of 5 kHz), and the measurement data can be processed and displayed on a mobile device locally, as well as transmitted through a Bluetooth communication module to a remote clinical service. The proposed interface pressure measuring system provides real-time interface pressure distribution data and can be utilized for both clinical and self-management of compression therapy, where both treatment efficacy and quality assurance can be ascertained. PMID:26530542

  14. Mean Platelet Volume in Patients with Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Mehmet Akif Sarıca

    2016-03-01

    Full Text Available Objective: the mean platelet volume (MPV is a good indicator of platelet activity; it is reported to increase in diseases associated with inflammatory processes and in vascular diseases. This study investigated the importance of mean platelet volume in patients with chronic venous insufficiency (CVI and whether the MPV was likely to be a predictor of the CVI. Methods: 117 patients who were diagnosed as CVI by colored Doppler Ultrasound (CDU method and 49 healthy volunteers (forming the control group were en­rolled to this study, which was planned retrospectively. The patients’ blood count values taken within one month before and after the CDU evaluation were recorded by the hospital information system. The complete blood count, routine biochemical tests and thyroid function tests of the patients diagnosed with CVI were compared to the control group. Results: Significant differences were not detected be­tween the patients and the control group in terms of the levels of creatinine, aspartate aminotransferase, total cholesterol, LDL cholesterol, HDL cholesterol, triglycer­ides, erythrocyte, sedimentation speed, leukocyte, hae­moglobin and thrombocyte (p>0.05. The thyroid stimulat­ing hormone and the MPV levels were significantly lower in the control group (p<0.05. Conclusion: MPV levels as an easy, cheap and practi­cal data extracted from complete blood count, were found higher in patients diagnosed with CVI compared to the control group. This may be originated from endothelium changes as an answer to venous hypertension and dila­tation in CVI. MPV can be used as a follow-up marker in CVI patients. J Clin Exp Invest 2016; 7 (1: 73-77

  15. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    NARCIS (Netherlands)

    J.A. Reekers; M.J. Lee; A.M. Belli; F. Barkhof

    2011-01-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the b

  16. [Phlebography in chronic venous insufficiency of the lower extremities. Technic and value of different tests].

    Science.gov (United States)

    Genevois, A; Bolot, J E; Michel, C

    1988-01-01

    Remainder of the various phlebographic procedures in chronic venous insufficiency of the lower extremities: peripheral phlebography, popliteal phlebography, femoral phlebography, varicography. The techniques and the informations they provide are presented for each one of these examinations. PMID:3043478

  17. Red blood cell deformability and aggregation in chronic venous disease patients with varicose veins

    OpenAIRE

    Karolina Słoczyńska; Mariusz Kózka; Henryk Marona

    2013-01-01

    Introduction: Red blood cells’ (RBC) rheological properties are disturbed in chronic venous disease (CVD). The aim of the study was to compare deformability and aggregation of erythrocytes taken from the varicose vein and the antecubital vein of patients with chronic venous disease.Materials and Methods: Blood samples were taken from twelve CVD patients presenting clinical, aetiological, anatomical and pathological elements (CEAP) stages II and III. Blood was sampled from varicose veins and a...

  18. Venous thrombosis.

    Science.gov (United States)

    Wolberg, Alisa S; Rosendaal, Frits R; Weitz, Jeffrey I; Jaffer, Iqbal H; Agnelli, Giancarlo; Baglin, Trevor; Mackman, Nigel

    2015-01-01

    Venous thromboembolism (VTE) encompasses deep-vein thrombosis (DVT) and pulmonary embolism. VTE is the leading cause of lost disability-adjusted life years and the third leading cause of cardiovascular death in the world. DVT leads to post-thrombotic syndrome, whereas pulmonary embolism can cause chronic pulmonary hypertension, both of which reduce quality of life. Genetic and acquired risk factors for thrombosis include non-O blood groups, factor V Leiden mutation, oral contraceptive use, hormone replacement therapy, advanced age, surgery, hospitalization and long-haul travel. A combination of blood stasis, plasma hypercoagulability and endothelial dysfunction is thought to trigger thrombosis, which starts most often in the valve pockets of large veins. Animal studies have revealed pathogenic roles for leukocytes, platelets, tissue factor-positive microvesicles, neutrophil extracellular traps and factors XI and XII. Diagnosis of VTE requires testing and exclusion of other pathologies, and typically involves laboratory measures (such as D-dimer) and diagnostic imaging. VTE is treated with anticoagulants and occasionally with thrombolytics to prevent thrombus extension and to reduce thrombus size. Anticoagulants are also used to reduce recurrence. New therapies with improved safety profiles are needed to prevent and treat venous thrombosis. For an illustrated summary of this Primer, visit: http://go.nature.com/8ZyCuY. PMID:27189130

  19. Stasis dermatitis and ulcers

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000834.htm Stasis dermatitis and ulcers To use the sharing features on this page, please enable JavaScript. Stasis dermatitis is a change in the skin that occurs ...

  20. The place of subfascial endoscopic perforator vein surgery (SEPS) in advanced chronic venous insufficiency treatment

    OpenAIRE

    2011-01-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5th and 6th degree of CEAP classification is still a great clinical challenge. In case of no satisfactory results of non-surgical treatment of recurrent venous ulcers, scientists search for alternative therapeutic methods which could be more effective and lasting. Subfascial endoscopic perforator vein surgery (SEPS) as a method of ...

  1. Horse chestnut – efficacy and safety in chronic venous insufficiency: an overview

    OpenAIRE

    Marlena Dudek-Makuch; Elżbieta Studzińska-Sroka

    2015-01-01

    ABSTRACTThe extract from horse chestnut seeds (Aesculus hippocastanumL., Sapindaceae), standardised for the content of aescin, is used as the treatment for chronic venous insufficiency. It has anti-inflammatory and anti-oedematous properties and indicates a positive effect on the venous tone, rheological properties, and blood coagulability. The mechanism of horse chestnut seed extract/aescin activity was proposed on the basis of in vitro and in vivo studies, and its effectiveness was document...

  2. Surveillance and medical therapy following endovascular treatment of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Forbes, Thomas L; Harris, Jeremy R; Kribs, Stewart W

    2012-06-01

    The debate regarding the possible link between chronic cerebrospinal venous insufficiency and multiple sclerosis (MS) is continuously becoming more and more contentious due to the current lack of level 1 evidence from randomized trials. Regardless of this continued uncertainty surrounding the safety and efficacy of this therapy, MS patients from Canada, and other jurisdictions, are traveling abroad to receive central venous angioplasty and, unfortunately, some also receive venous stents. They often return home with few instructions regarding follow-up or medical therapy. In response we propose some interim, practical recommendations for post-procedural surveillance and medical therapy, until further information is available. PMID:22577160

  3. Elastic compression treatment of chronic superficial venous insufficiency of the lower limbs based on Doppler venous pressure index measurements

    Directory of Open Access Journals (Sweden)

    Leonardo Corcos

    2015-03-01

    Full Text Available Ineffectiveness or discomfort from graduated elastic compression stockings (GES in patients with chronic venous insufficiency (CVI and/or varicose veins of the lower limbs (VVLL can depend of inappropriate counter pressure applied. Counter pressure was calculated by Doppler venous pressure index (VPI. The aim of this study was to verify the value VPI in the choice of GES. A total of 1212 LL of 606 patients subjected to VPI measurements VPI correlated with the various sites of reflux (R and C of Clinical-Etiology-Anatomy-Pathophysiology (CEAP classification. The difference between standing VPI the and normal values=counter pressure to be applied by GES. Questionnaire to 96 patients with CVI/VVLL wearing GES. Mean VPI values: greater saphenous (GSV>smaller saphenous; GSV with isolated venous reflux (R at the leg>GSV at the thigh; additional R in perforators increases VPI in all the districts; superficial R increases VPI in PT. Relation between VPI/C of CEAP: P<0.05-0.0001; 81/83/96 (97.5% patients improved; 0 complained. R in GSV at the leg and in perforators increases VPI in deep veins. Few discrepancies VPI/CEAP can be expected. Standing VPI is highly predictive. The best choice of GES can be based on the VPI measurement.

  4. Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country.

    Science.gov (United States)

    Nag, Falguni; De, Abhishek; Hazra, Avijit; Chatterjee, Gobinda; Ghosh, Arghyaprasun; Surana, Trupti V

    2014-10-01

    Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries. PMID:23170845

  5. Status of the valves in the superficial and deep venous system in chronic venous disease.

    Science.gov (United States)

    van Bemmelen, P S; Bedford, G; Beach, K; Strandness, D E

    1991-06-01

    The relationship between the functional status of the venous valves in the superficial and deep veins and ulceration was evaluated in 42 patients. Twenty-five patients had ulcers, 12 of these patients had a history of previous deep venous thrombosis and 13 of these patients denied such an event. Seventeen patients had normal ankle skin, 10 of these patients had a documented history of deep vein thrombosis and seven of these patients had varicose veins only. An ultrasonic duplex scanner was used to document the presence of reflux in all segments of the superficial and deep system. In the entire group of 25 limbs with ulceration, valvular incompetence was noted in 22 limbs at levels involving segments that communicated with the ulcer-bearing area. Of the 17 limbs with normal ankle skin, in only two instances was a single segment of posterior tibial vein in midcalf found to be incompetent. For those patients with normal ankle skin and a history of varicose veins, the deep veins below the common femoral vein level were always competent. PMID:2042091

  6. Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Marcelo Henrique da Silva

    2014-08-01

    Full Text Available Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions.

  7. Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers

    DEFF Research Database (Denmark)

    Karlsmark, T; Agerslev, R H; Bendz, S H;

    2003-01-01

    OBJECTIVE: This study aimed to evaluate the safety and performance of a new sustained silver-releasing dressing, Contreet Foam (Coloplast A/S), in the treatment of moderately to highly exuding chronic venous leg ulcers in which healing is delayed due to the presence of bacteria. METHOD: The...... clinical performance of Contreet Foam was studied for four weeks in 25 patients with moderately to highly exuding delayed-healing venous leg ulcers. Healing was assessed on a weekly basis with reference to the wound-bed tissue composition, degree of odour and pain, dressing performance and the dressing......: Contreet Foam was found to be safe and performed well when used in the treatment of delayed-healing chronic venous leg ulcers, combining effective antibacterial properties with excellent exudate management. DECLARATION OF INTEREST: This study was supported by Coloplast A/S, Humlebaek, Denmark....

  8. Chronic venous leg ulcers: is topical zinc the answer? A review of the literature

    OpenAIRE

    O'Connor, Siobhan; Murphy, Siobhan

    2014-01-01

    PURPOSE: To enhance the learner's competence with knowledge of research data on topical zinc for treatment of chronic leg ulcers. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to: ABSTRACT: Venous leg ulcers (VLUs) are chronic leg wounds that can have a debilitating effect on the physical a...

  9. Horse chestnut – efficacy and safety in chronic venous insufficiency: an overview

    Directory of Open Access Journals (Sweden)

    Marlena Dudek-Makuch

    2015-10-01

    Full Text Available ABSTRACTThe extract from horse chestnut seeds (Aesculus hippocastanumL., Sapindaceae, standardised for the content of aescin, is used as the treatment for chronic venous insufficiency. It has anti-inflammatory and anti-oedematous properties and indicates a positive effect on the venous tone, rheological properties, and blood coagulability. The mechanism of horse chestnut seed extract/aescin activity was proposed on the basis of in vitro and in vivo studies, and its effectiveness was documented with numerous randomised clinical trials. The results of the studies have proven that horse chestnut seed extract not only significantly improves subjective symptoms in patients with chronic venous insufficiency like calf spasm, leg pain, pruritus, fatigue, but it also reduced leg volume, the ankle and calf circumference. The preparations containing horse chestnut seed extract are very popular and they have similar effectiveness as compression therapy and a preparation with O-(β-hydroxyethyl-rutosides. Moreover, horse chestnut seed extract has been proven to be safe and very well tolerated. The study was to present the results of the studies that have been conducted so far and that have confirmed the effectiveness of use of horse chestnut seed extract or aescin as the treatment for chronic venous insufficiency.

  10. Matrix metalloproteinase activity and glycosaminoglycans in chronic venous disease: the linkage among cell biology, pathology and translational research

    OpenAIRE

    Mannello, Ferdinando; Raffetto, Joseph D.

    2010-01-01

    Primary chronic venous disease (CVD) is an inflammatory pathology involving an erratic structural remodeling in the venous well leading to vascular incompetence and the development of varicose vein, characterized by altered collagen and elastin content. In the early steps of varicose vein formation is crucial the role of MMP/TIMP balance, implicated in both ECM and vascular degradation during inflammation processes in early and late stages of venous diseases. Although several pharmacological ...

  11. Effect of Multi-layer Compression Bandage Systems on Leg Ulcers Associated with Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Hüseyin Kuplay

    2013-03-01

    Full Text Available Introduction: Venous leg ulcer is a major health problem in terms of high prevalence and high cost for treatment. Multi-layer compression bandage systems for venous leg ulcers are supposed to be the gold standard for the treatment of venous ulcers. The aim of the current study is to investigate the effectiveness of multi-layer compression bandage systems for the treatment of venous leg ulcers.Patients and Methods: Nineteen consecutive patients diagnosed to have leg ulcers were evaluated and four patients were excluded from the study due to the peripheral arterial disease. Fifteen patients, enrolled in the study, were classified according to CEAP classification and belonged to the same class. Betaven® multi-layer compression bandage was applied to patients. Patients were followed-up in terms of wound healing and reduction in wound diameter.Results: Twelve male and three female patients underwent multi-layer bandage system. Mean age of patients was 38.2 ± 4.2 years. Ulcer size was measured planimetrically and baseline ulcer size was 4-10 cm². The location of ulcer was on medial malloelus in seven patients, lateral malleolus in three patients, anterior surface of the leg in four patients and lateral side of the leg in one patient. Patients had chronic venous insuuficiency for a mean of 5.1 ± 2.1 years. CEAP classifications were C6, Ep, As2,3-p18, Pr2,3, 18. Each bandage was changed five days after application along with wound care. Mean duration of treatment was 6 ± 2 weeks. Complete healing of the venous ulcers occurred in all patients except for one. This patient was referred to plastic surgery clinic for reconstruction.Conclusion: Multi-layer compression bandage system is an effective method of treatment for venous leg ulcers associated with chronic venous insufficiency by reducing venous return and increasing intertitial tissue pressure. This effect occurred in the shortrun as well as with a low cost and prevented loss of labor.

  12. Evaluation of quality of life and photoplethysmography in patients with chronic venous insufficiency treated with foam sclerotherapy

    Directory of Open Access Journals (Sweden)

    Felipe Coelho Neto

    2015-06-01

    Full Text Available BACKGROUND: Ultrasound-guided foam sclerotherapy plays a major role in treatment of chronic venous insufficiency, providing clinical and hemodynamic improvement to patients undergoing treatment.OBJECTIVES: To examine the relationships between venous refilling time and impact of venous disease on quality of life and between changes in venous refilling time and improvement of symptoms after ultrasound-guided foam sclerotherapy for chronic venous insufficiency.METHODS: Thirty-two patients classified as C4, C5 or C6 answered a questionnaire on quality of life and symptoms and their venous filling time was measured using photoplethysmography before and 45 days after treatment of chronic venous insufficiency with ultrasound-guided foam sclerotherapy.RESULTS: Statistically significant improvements were observed in quality of life scores and in venous filling time and in the following symptoms: aching, heavy legs, restless legs, swelling, burning sensations, and throbbing (p<0.0001. A similar improvement was also seen in the work and social domains of quality of life (p<0.0001.CONCLUSIONS: As confirmed by questionnaire scores and venous refilling times, ultrasound-guided foam sclerotherapy demonstrated efficacy and resulted in high satisfaction levels and low rates of major complications.

  13. Effects of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion. Preliminary results

    International Nuclear Information System (INIS)

    The present study was designed to reveal the usefulness of acupuncture for chronic pelvic pain syndrome with intrapelvic venous congestion as evaluated by symptom scores, transrectal ultrasonography (TRUS) and magnetic resonance (MR) venography. Ten male patients suffering from non-inflammatory chronic pelvic pain syndrome (National Institutes of Health (NIH) category IIIB) with intrapelvic venous congestion were treated using acupuncture. Eight patients had previously received pharmacotherapy, which was unsuccessful. Acupuncture was performed using disposable stainless steel needles, which were inserted into the bilateral BL-33 points and rotated manually for 10 min. The treatment was repeated every week for 5 weeks without other therapeutic maneuvers. Results from TRUS and MR venography, as well as clinical symptoms based on the NIH chronic prostatitis symptom index (NIH-CPSI) and the international prostate symptom score (IPSS), were compared before and after the treatment. No side-effects were recognized throughout the treatment period. The average pain and quality of life (QOL) scores of the NIH-CPSI 1 week after the 5th acupuncture treatment decreased significantly (P<0.05 and P<0.01, respectively) compared with the baseline. The maximum width of the sonolucent zone 1 week after the 5th treatment also decreased significantly (P<0.01, compared with the baseline). Intrapelvic venous congestion demonstrated by MR venography was significantly improved in four patients. This study provided novel information concerning the therapeutic effects of acupuncture on non-inflammatory chronic pelvic pain syndrome. (author)

  14. Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Hojnacki David

    2011-10-01

    Full Text Available Abstract Background The potential pathogenesis between the presence and severity of chronic cerebrospinal venous insufficiency (CCSVI and its relation to clinical and imaging outcomes in brain parenchyma of multiple sclerosis (MS patients has not yet been elucidated. The aim of the study was to investigate the relationship between CCSVI, and altered brain parenchyma venous vasculature visibility (VVV on susceptibility-weighted imaging (SWI in patients with MS and in sex- and age-matched healthy controls (HC. Methods 59 MS patients, 41 relapsing-remitting and 18 secondary-progressive, and 33 HC were imaged on a 3T GE scanner using pre- and post-contrast SWI venography. The presence and severity of CCSVI was determined using extra-cranial and trans-cranial Doppler criteria. Apparent total venous volume (ATVV, venous intracranial fraction (VIF and average distance-from-vein (DFV were calculated for various vein mean diameter categories: .9 mm. Results CCSVI criteria were fulfilled in 79.7% of MS patients and 18.2% of HC (p Conclusions MS patients with higher number of venous stenoses, indicative of CCSVI severity, showed significantly decreased venous vasculature in the brain parenchyma. The pathogenesis of these findings has to be further investigated, but they suggest that reduced metabolism and morphological changes of venous vasculature may be taking place in patients with MS.

  15. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ).

    Science.gov (United States)

    Launois, R; Reboul-Marty, J; Henry, B

    1996-12-01

    Quality of life may be considerably reduced in patients who are suffering from chronic lower limb venous insufficiency, although existing generic quality of life instruments (NHP, SF-36 or SIP) cannot completely identify their specific complaints. The Chronic Venous Insufficiency Questionnaire (CIVIQ) has been developed by iterative process. First, a pilot group of 20 patients was used to identify a number of important features of quality of life affected by venous insufficiency, other than physical symptoms of discomfort. A second study involving 2,001 subjects was used to reduce the number of items. Subjects were asked to score both the severity of their problems and the importance they attributed to each problem on a 5-point Likert scale. The importance items found in patients with venous insufficiency were subjected to factorial analyses (PCA, PAF). The final version is a 20-item self-administered questionnaire which explores four dimensions: psychological, physical and social functioning and pain. Internal consistency of the questionnaire was validated for each dimension (Cronbach's alpha > 0.820 for three out of four factors). Reproducibility was confirmed in a 60 patient test-retest study. Pearson's correlation coefficients for both the four dimension subscales and for the global score at 2-week intervals were greater than 0.940. Finally, the questionnaire was tested in a randomized clinical trial of 934 patients in order to assess responsiveness and the convergent validity of the instrument, together with the patient's own quality of life. This study demonstrated that convergence was valid: Pearson's correlation coefficients between clinical score differences and quality of life score differences were small (from 0.199-0.564) but were statistically different from 0 (p response mean (SRM) and effect size (ES) were calculated to assess sensitivity to change. SRM and ES both demonstrated considerable responsiveness to change (> 0.80). Reliability, face

  16. Protocol for the realization of venous mapping by chronic venous insufficiency in lower limbs under sonographic guide

    International Nuclear Information System (INIS)

    The current state of knowledge is reviewed with respect to the realization of lower limbs venous mapping. Venous mapping is obtained by the use of color and spectral Doppler ultrasound. Doppler ultrasound has provided a precise graphical representation of the superficial and deep venous systems. The performance of the venous mapping is considered essential for the correct handling of venous diseases. The anatomical and pathophysiological basic concepts are defined to realize the sonographic assessment of the veins of the lower limbs. The required technical aspects are revised for the realization of sonographic exploration of the patient with venous insufficiency. Sonographic findings are characterized to support the diagnostic of venous insufficiency of the lower limbs. The CEAP (clinical-etiologic-anatomic-pathophysiologic) classification is utilized to differentiate forms and degrees of severity of the disorder, and has allowed an interinstitutional comparison in clinical studies, the evaluation of treatment and monitoring of patients. A proposal is designed to perform reports that have served of guide surgical to vascular surgeons

  17. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

    OpenAIRE

    Novović Miloš; Topić Vesna

    2012-01-01

    Introduction. Arterial blood gas (ABG) analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG) values of pH, partial pressure of carbon dioxide (PCO2), partial o...

  18. Saphenofemoral ligation as a safe and effective alternative for the treatment of chronic venous leg ulcer

    International Nuclear Information System (INIS)

    To evaluate the effectiveness and safety of isolated saphenofemoral junction ligation for the treatment of chronic venous leg ulcer in comparison to traditional stripping procedure. 36 patients (28 men and 8 women) with mean age of 42.3+-8.7, presented with a venous leg ulcer. After taking the full history, they underwent examination for presence of edema, cellulitis or local ulcer infection. The site and size of ulceration were recorded and ankle-brachial pressure index (ABPI) was measured, Venous valvular incompetence was assessed using Valsalva testand calf compression. Patients were divided into 2 groups. Group I, (n=10) assigned for long saphenous stripping, while group II (n=26) assigned for saphenofemoral ligationan and divided combined with ligation of major tributaries under local infiltration anesthesia. Mean operative time, postoperative complications and hospital stay were recorded. The study was carried out in Benha University Hospital, Egypt and Armed Forces Hospital, Southern Region, Khamis Mushayt, Sadi Arabia between January 2000 and December 2001. The mean operative time and the hospital stay were significantly (p<0.05) reduced in group II compared to group I. The postoperative complications were signficantly (x=7.5, p<0.05) reduced in group II. Ulcer healing started after 3 months in group II and six months in group I, but by 12 month, group II had significant (x=6.7, p<0.05) number of healed ulcers (n=22, 84.6%), compared to group I (n=7, 70%). The isolated ligation of of saphenofemoral junction is a minimally invasive, safe and effective modality for treatment of chronic leg ulcer, and being easily performed under local anesthesia and considerd to be a satisfactory procedure for treatment of leg ulcer in patients who are unfit for general anesthesia. (author)

  19. Evaluation of chronic cerebrospinal venous insufficiency (CCSVI) occurrence in a group of 34 MS patients

    International Nuclear Information System (INIS)

    Background: Zamboni et al announced research results showing significant alterations in venous outflow from the brain, chronic cerebrospinal venous insufficiency (CCSVI), and its possible connections with multiple sclerosis (MS). The findings evoked wide interest all over the world. The scientists found 100% sensitivity and specificity in detection of at least 2 CCSVI parameters in MS-diagnosed patients in contrast to healthy controls and patients with other neurological disorders. Researchers at several centers decided to verify these reports, finding CCSVI incidence in MS patients ranging from 0 % to 90 %. The aim of this study was to evaluate the frequency of chronic cerebrospinal venous insufficiency according to Zambonis criteria in patients with MS. Material/Methods: The study group included 34 patients with multiple sclerosis diagnosed according to the revised McDonald criteria. All patients underwent ultrasound evaluation for the presence of 5 CCSVI criteria in accordance with the methodology described by Zamboni et al. Results: In the group of 34 MS patients, 9 (26.5 %) were diagnosed with CCSVI (6 of them with RR course, 2 with SP course and 1 with PP course), 23 patients (67.6 %) met 1 of the 5 diagnostic criteria, and 2 patients (5.9 %) did not meet any criterion. Conclusions: Based on the criteria published by Zamboni et al. in the study group of 34 MS patients, CCSVI was diagnosed in 9, which is 26.5 % of the total. Lack of standardized methodology of the examination can cause a large divergence of results obtained in various centers. The hypothesis that CCSVI is a possible cause of MS is worthy of further studies and should not be rejected without evaluation by properly designed clinical trials. (authors)

  20. Magnetic Resonance Venography of chronic cerebrospinal venous insufficiency in patients with associated multiple sclerosis

    International Nuclear Information System (INIS)

    Background: Multiple sclerosis (MS) is a chronic disease with not well understood etiology. Recently, a possible association of MS with compromised venous outflow from the brain and spinal cord has been studied (chronic cerebrospinal venous insufficiency - CCSVI). Angioplasties of internal jugular veins (IJV) and azygous vein (AV) have given promising results, with improvements in patients clinical status. Material/Methods: 830 patients with clinically defined MS were scanned from the level of sigmoid sinuses to the junction with brachiocephalic veins, as well as at the level of AV. T2-weighted, 2D TOF and FIESTA sequences were used. Results: The examination revealed a slower blood flow in IJVs, in 98% of patients: on the right side - in 6%, on the left side - in 15%, on both sides with right-side predominance - in 22%, on both sides with left-side predominance - in 34%, bilaterally with no side predominance - in 19%. In 2%, there was a slower blood flow in IJVs, vertebral veins and subclavian veins and also in the left brachiocephalic vein. Moreover, in 5% of patients there was a decreased blood flow in the azygous vein. Conclusions: Abnormal flow pattern in IJVs is more common on the left side. Less often it can be found in azygous vein and in brachiocephalic veins. Further research is needed to investigate the significance of CCSVI in MS patients. The protocol we described can be used for most of modern magnetic resonance units. (authors)

  1. The Application of Negative Pressure Wound Therapy in the Treatment of Chronic Venous Leg Ulceration: Authors Experience

    Directory of Open Access Journals (Sweden)

    Marek Kucharzewski

    2014-01-01

    Full Text Available The aim of the study was to use negative pressure wound therapy (NPWT in patients with chronic venous leg ulceration. The authors present their experience in treatment of 15 patients whose average ulceration surface area was 62.6 cm2. In 10 patients, the ulcers healed within 6 weeks and in the remaining patients within 20 weeks. Based on the results obtained, the authors imply that NPWT is an effective method in the treatment of chronic venous leg.

  2. Transplantation of autologous keratinocyte suspension in fibrin matrix to chronic venous leg ulcers: improved long-term healing after removal of the fibrin carrier.

    NARCIS (Netherlands)

    Hartmann, A.; Quist, J.; Hamm, H.; Brocker, E.B.; Friedl, P.H.A.

    2008-01-01

    BACKGROUND: The transplantation of keratinocytes suspended in fibrin carrier represents a candidate regimen for chronic ulcer treatment in an outpatient setting. We evaluated the integration and survival of autologous individualized keratinocytes applied within fibrin matrix onto chronic venous leg

  3. Application of promoting blood circulation by removing blood stasis in treatment of chronic hepatitis B patients%活血化瘀法在慢性乙型肝炎治疗中的运用探讨

    Institute of Scientific and Technical Information of China (English)

    周虎; 宋薇薇; 徐文斌; 俞冠东

    2011-01-01

    目的 探讨慢性乙型肝炎患者(以下简称慢肝)是否存在免疫机能紊乱,活血化瘀疗法是否能改善慢性乙型肝炎患者免疫功能.方法 慢肝患者120例免疫球蛋白,T淋巴细胞亚群与20例健康对照组比较.将120例慢肝随机分为辨证组(A组)21例,活血化瘀组(B组)15例,辨证加活血化瘀组(C组)65例.结果 慢肝患者存在免疫功能紊乱,治疗后C组疗效明显高于其他两组.结论 在辨证基础上加活血化瘀的中药,能调整慢肝患者的免疫功能,显著提高治疗慢肝临床疗效.%Objective To discuss whether there is immune dysfunction in chronic hepatitis b patients and whether promoting blood circulation by removing blood stasis could improve immune function of them. Methods Compare immunoglobulin and T lymphocyte subsets of 120 chronic hepatitis B patients and 20 healthy people. 120 chronic hepatitis B patients were grouped A, B and C by using random grouping test method. Group A which contains 21 patients, were treated with syndrome differentiation treatment, group B 15 patients, with promoting blood circulation by removing blood stasis, and group C 65 patients, with both treatment. Results There is immune dysfunction in chronic hepatitis B patients, and patients in group C got better curative effect than those in the other 2 groups. Conclusion Promoting blood circulation by removing blood stasis on the basis of syndrome differentiation treatment could improve immune function of chronic hepatitis B patients, and improve the curative effect significantly.

  4. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    LENUS (Irish Health Repository)

    Reekers, J A

    2011-02-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and\\/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the "venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. However, this theory does not fit into the existing bulk of scientific data concerning the pathophysiology of MS. In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence. Furthermore, most of the information we have comes from one source only. The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment. However, there are no data available from patients who underwent unsuccessful treatments with which to obtain a more balanced view. The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment. In addition, many interventional radiologists

  5. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Reekers, J A; Lee, M J; Belli, A M; Barkhof, F

    2011-02-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS) [1]. The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the "venous hemodynamic insufficiency severity score" (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits [2]. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. However, this theory does not fit into the existing bulk of scientific data concerning the pathophysiology of MS. In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence. Furthermore, most of the information we have comes from one source only. The treatment is called "liberation treatment," and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment. However, there are no data available from patients who underwent unsuccessful treatments with which to obtain a more balanced view. The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment. In addition, many interventional radiologists

  6. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    International Nuclear Information System (INIS)

    Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS). The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the “venous hemodynamic insufficiency severity score” (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. However, this theory does not fit into the existing bulk of scientific data concerning the pathophysiology of MS. In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence. Furthermore, most of the information we have comes from one source only. The treatment is called “liberation treatment,” and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment. However, there are no data available from patients who underwent unsuccessful treatments with which to obtain a more balanced view. The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment. In addition, many interventional radiologists

  7. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum.

    Science.gov (United States)

    Gloviczki, Peter; Comerota, Anthony J; Dalsing, Michael C; Eklof, Bo G; Gillespie, David L; Gloviczki, Monika L; Lohr, Joann M; McLafferty, Robert B; Meissner, Mark H; Murad, M Hassan; Padberg, Frank T; Pappas, Peter J; Passman, Marc A; Raffetto, Joseph D; Vasquez, Michael A; Wakefield, Thomas W

    2011-05-01

    The Society for Vascular Surgery (SVS) and the American Venous Forum (AVF) have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis. The document also includes recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases (CVDs), including edema, skin changes, or venous ulcers. Recommendations of the Venous Guideline Committee are based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system as strong (GRADE 1) if the benefits clearly outweigh the risks, burden, and costs. The suggestions are weak (GRADE 2) if the benefits are closely balanced with risks and burden. The level of available evidence to support the evaluation or treatment can be of high (A), medium (B), or low or very low (C) quality. The key recommendations of these guidelines are: We recommend that in patients with varicose veins or more severe CVD, a complete history and detailed physical examination are complemented by duplex ultrasound scanning of the deep and superficial veins (GRADE 1A). We recommend that the CEAP classification is used for patients with CVD (GRADE 1A) and that the revised Venous Clinical Severity Score is used to assess treatment outcome (GRADE 1B). We suggest compression therapy for patients with symptomatic varicose veins (GRADE 2C) but recommend against compression therapy as the primary treatment if the patient is a candidate for saphenous vein ablation (GRADE 1B). We recommend compression therapy as the primary treatment to aid healing of venous ulceration (GRADE 1B). To decrease the recurrence of venous ulcers, we recommend ablation of the incompetent superficial veins in addition to compression therapy (GRADE 1A). For treatment of the incompetent great saphenous vein (GSV), we recommend endovenous thermal ablation (radiofrequency or laser) rather than high ligation and inversion stripping

  8. A Clinical Comparison of Pycnogenol, Antistax, and Stocking in Chronic Venous Insufficiency.

    Science.gov (United States)

    Belcaro, Gianni

    2015-12-01

    This 8-week registry study was a comparative evaluation of Pycnogenol (French Maritime Pine Bark extract; Horphag Research, Geneva) and Antistax (grape leaf extract [GLE, Boehringer Ingelheim, Germany]) in controlling symptoms of chronic venous insufficiency (CVI). "Standard management" for CVI is compression; a group of comparable subjects was monitored to evaluate the effects of stockings. The registry included 183 patients (166 completing). Supplementation with Antistax (two tablets of 360 mg/d) or Pycnogenol (100 mg/d) was used. The groups were comparable for age, symptoms, venous incompetence, and microcirculation (with increased capillary filtration and skin flux) at inclusion. At 8 weeks, the rate of swelling (p Pycnogenol (p Pycnogenol (p Pycnogenol. An analog scale quantified symptoms. At 8 weeks, pain and edema were decreased with Pycnogenol and elastic compression (p Pycnogenol (p Pycnogenol was decreased by 40%. Induration was reduced only in the Pycnogenol group (p Pycnogenol were lower (96; 3.3 Euros) in comparison with the other groups (132;1.4 Euros for GLE and 149; 2.2 Euros for compression). PMID:26648668

  9. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    Directory of Open Access Journals (Sweden)

    Saranat Orrapin

    2016-01-01

    Full Text Available Chronic traumatic arteriovenous fistula (AVF commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1 and shotgun wounds (case 2. Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance.

  10. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities.

    Science.gov (United States)

    Orrapin, Saranat; Arworn, Supapong; Rerkasem, Kittipan

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT) in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance. PMID:27293948

  11. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    Science.gov (United States)

    Orrapin, Saranat; Arworn, Supapong; Rerkasem, Kittipan

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases large venous aneurysm was found next to a large AVF. An open surgical AVF closure for the large AVF was performed in case 1 successfully, but patient developed acute deep vein thrombosis (DVT) in a large venous aneurysm. In the second case, in order to prevent DVT, only closure of the large AVF was performed, which preserved arterial flow into the venous aneurysm. Case 2 did not have acute DVT. This report raised the concern about acute DVTs in venous aneurysms following the closure of chronic traumatic AVF in terms of prevention. Also chronic traumatic AVF is commonly due to misdiagnosis in the initial treatment, so complete and serial physical examinations in penetrating vascular injury patients are of paramount importance. PMID:27293948

  12. Relationship Between Pain and CEAP C Categories of Chronic Venous Disease.

    Science.gov (United States)

    Radak, D J; Tanaskovic, S Z; Vlajinac, H D; Marinkovic, J M; Maksimovic, M Z

    2016-08-01

    In this study, we investigated whether the occurrence and intensity of leg pain are related to C class of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification for chronic venous disease (CVeD). This cross-sectional study, conducted in Serbia, included 2841 patients: 2027 (71.3%) women and 814 (28.7%) men with CVeD diagnosed by general practitioners. For the first time, the Numeric Rating Scale of 0 to 5 units was used to assess the intensity of pain. For the analysis, univariate and multivariate logistic and linear regressions were applied. Pain in the legs was reported by 90.5% of the patients. The occurrence of pain significantly (P family history of CVeD. PMID:26483571

  13. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Novović Miloš

    2012-01-01

    Full Text Available Introduction. Arterial blood gas (ABG analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD. Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG values of pH, partial pressure of carbon dioxide (PCO2, partial oxygen pressure (PO2, bicarbonate (HCO3, and venous and arterial blood oxygen saturation (SO2 can reliably predict ABG levels in patients with acute exacerbation of COPD. Methods. Forty-seven patients with a prior diagnosis of COPD were included in this prospective study. The patients with acute exacerbation of this disease were examined at the General Hospital EMS Department in Prijepolje. ABG samples were taken immediately after venous sampling, and both were analyzed. Results. The Pearson correlation coefficients between arterial and venous parameters were 0.828, 0.877, 0.599, 0.896 and 0.312 for pH, PCO2, PO2, HCO3 and SO2, respectively. The statistically significant correlation between arterial and venous pH, PCO2 and HCO3, values was found in patients with acute exacerbation of COPD (p<0.001. Conclusion. When we cannot provide arterial blood for analysis, venous values of the pH, Pv,CO2 and HCO3 parameters can be an alternative to their arterial equivalents in the interpretation of the metabolic status in patients with acute exacerbation of COPD, while the values of venous Pv,O2 and Sv,O2 cannot be used as predictors in the assessment of oxygen status of such patients.

  14. Korean Studies on Blood Stasis: An Overview

    OpenAIRE

    Bongki Park; Sooseong You; Jeeyoun Jung; Ju Ah Lee; Kyung-Jin Yun; Myeong Soo Lee

    2015-01-01

    Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews...

  15. Cost-effective use of silver dressings for the treatment of hard-to-heal chronic venous leg ulcers

    DEFF Research Database (Denmark)

    Jemec, Gregor B E; Kerihuel, Jean Charles; Ousey, Karen;

    2014-01-01

    AIM: To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). BACKGROUND: Chronic venous ulceration affects 1-3% of the adult population and typically has a protracted course of healing......, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial....... METHODS: A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: 'Healed ulcer', 'Healing ulcer' or 'No improvement' were developed, reflecting the relative reduction in ulcer...

  16. Which plant for which skin disease? Part 2: Dermatophytes, chronic venous insufficiency, photoprotection, actinic keratoses, vitiligo, hair loss, cosmetic indications.

    Science.gov (United States)

    Reuter, Juliane; Wölfle, Ute; Korting, Hans Christian; Schempp, Christoph

    2010-11-01

    This paper continues our review of scientifically evaluated plant extracts in dermatology. After plants effective against dermatophytes, botanicals with anti-edema effects in chronic venous insufficiency are discussed. There is good evidence from randomized clinical studies that plant extracts from grape vine leaves (Vitis vinifera), horse chestnut (Aesculus hippocastanum), sea pine (Pinus maritima) and butcher's broom (Ruscus aculeatus) can reduce edema in chronic venous insufficiency. Plant extracts from witch hazel (Hamamelis virginiana), green tea (Camellia sinensis), the fern Polypodium leucotomos and others contain antioxidant polyphenolic compounds that may protect the skin from sunburn and photoaging when administered topically or systemically. Extracts from the garden spurge (Euphorbia peplus) and from birch bark (Betula alba) have been shown to be effective in the treatment of actinic keratoses in phase II studies. Some plant extracts have also been investigated in the treatment of vitiligo, various forms of hair loss and pigmentation disorders, and in aesthetic dermatology. PMID:20707877

  17. Diagnostic concordance of the dilation of the great saphenous vein in patients with chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Reyes-Lobo Alexander

    2012-12-01

    Full Text Available Introduction: Chronic venous insufficiency (CVI is a dysfunction of the venous systemof the inferior limbs, in which it is formed a venovenous short circuit with alteration inthe physiologic flow of the blood.Objective: To estimate the degree of diagnostic concordance between the dilation ofthe great saphenous vein and the presence of chronic venous insufficiency (CVI.Methods: Diagnostic concordance study, where were included all the patients that wentbetween the months of April and May 2011 to the service of radiology of the HospitalUniversitario del Caribe, Cartagena, Colombia to make itself a colour Doppler ultrasoundof inferior limbs because of suspicion of CIV. Data was saved and analyzed by meansof the statistical program EPI-INFO version 3.5.1. Statistical analysis was focused inthe estimation of the kappa concordance index, the diameter of the saphenous with thepresence of CVI. Moreover there were calculated the parameters of diagnostic validitylike sensibility, specificity, predictive values and probability quotient.Results: There were recruited 77 patients, 64 women and 13 men. Of the total ofpatients, 47 had ebb and of them, 41 had dilation of the great saphenous vein, for whatthe dilation of this vein per se has sensibility of 87.2% and specificity of 93,1% for thediagnosis of CVI with positive predictive value (PPV of 95.3% and negative predictivevalue of 81.8%.Conclusion: There is good diagnostic concordance between the dilation of the greatsaphenous vein and the CVI. Rev.cienc.biomed. 2012;3(2:234-241RESUMEN:INTRODUCCIÓN: la Insuficiencia Venosa Crónica (IVC es una disfunción del sistemavenoso de los miembros inferiores, en la que se forma un corto circuito veno-venosocon alteración en el flujo fisiológico de la sangre.OBJETIVO: estimar el grado de concordancia diagnóstica entre la dilatación de la venasafena mayor y la presencia de insuficiencia venosa crónica (IVC.METODOLOGÍA: estudio de concordancia diagnóstica, en el

  18. Predictors of chronic cerebrospinal venous insufficiency procedure use among older people with multiple sclerosis: a national case–control study

    OpenAIRE

    Ploughman, Michelle; Manning, Olivia J; Beaulieu, Serge; Harris, Chelsea; Hogan, Stephen H; Mayo, Nancy; Fisk, John D; Sadovnick, A. Dessa; O’Connor, Paul; Morrow, Sarah A.; Metz, Luanne M.; Smyth, Penelope; Allderdice, Penelope W; Scott, Susan; Marrie, Ruth Ann

    2015-01-01

    Background Following the initial reports of Chronic Cerebrospinal Venous Insufficiency (CCSVI) and the purported curative potential of venoplasty, (coined the ‘liberation’ procedure) Canadians living with multiple sclerosis (MS) began to travel abroad to receive the unregulated procedure, often placing them at odds with their health providers. The purpose of this study was to determine the factors influencing older MS patients’ decision to undergo the procedure in order to develop more specif...

  19. Patients' reported quality of life in chronic venous disease in an outpatient service in Belgrade, Serbia.

    Science.gov (United States)

    Dunić, Ivana; Medenica, Ljiljana; Bobić, Branko; Djurković-Djaković, Olgica

    2009-01-01

    Chronic venous disease (CVD) has been reported to substantially affect patients' quality of life (QoL). To evaluate the impact of CVD on patient-reported QoL in a patient series in Serbia, a cross-sectional study of 570 CVD patients, classified according to the CEAP clinical classification into classes (C) 1-6, was performed in a Belgrade outpatient clinic. QoL was assessed by the general short-form (SF)-36 questionnaire, and additionally by a brief CVD-specific questionnaire. The SF-36 scores for all QoL dimensions showed a progressive reduction from C1 to C6. Class 5 and 6 patients scored the lowest across all dimensions, with significant (p social functioning and emotional role scores across the groups. There were no age or gender differences in any QoL item across the classes. The data presented show that QoL of CVD patients decreases, particularly after the appearance of skin changes, and suggest that even patients in the early stages consider CVD a disease and not merely a cosmetic problem. PMID:19737727

  20. Chronic cerebrospinal venous insufficiency in multiple sclerosis: a highly prevalent age-dependent phenomenon

    Directory of Open Access Journals (Sweden)

    Lanzillo Roberta

    2013-02-01

    Full Text Available Abstract Background This study aimed to investigate the prevalence and clinical relevance of chronic cerebrospinal venous insufficiency (CCSVI in multiple sclerosis (MS patients and healthy controls using extra- and intracranial colour Doppler sonography. Methods We examined 146 MS patients, presenting with a clinically isolated syndrome, relapsing-remitting, secondary progressive, or primary progressive MS, and 38 healthy controls. Sonographic examination was performed according to Zamboni’s protocol and was performed by three independent sonographers. The results of sonographic examination were compared with clinical and demographic characteristics of the patients. Results CCSVI, defined as the presence of at least two positive Zamboni’s criteria, was found in 76% of MS patients and 16% of control subjects. B-mode anomalies of internal jugular veins, such as stenosis, malformed valves, annuli, and septa were the most common lesions detected in MS patients (80.8% and controls (47.4%. We observed a positive correlation between sonographic diagnosis of CCSVI and the patients’ age (p = 0.003. However, such a correlation was not found in controls (p = 0.635. Notably, no significant correlations were found between sonographic signs of CCSVI and clinical characteristics of MS, except for absent flow in the jugular veins, which was found more often in primary (p Conclusions Sonographically defined CCSVI is common in MS patients. However, CCSVI appears to be primarily associated with the patient’s age, and poorly correlated with the clinical course of the disease.

  1. Nutritional profile of older adults with chronic venous leg ulcers: a pilot study.

    Science.gov (United States)

    McDaniel, Jodi C; Kemmner, Kaitlyn G; Rusnak, Sarah

    2015-01-01

    The purpose of this cross-sectional descriptive pilot study was to describe daily intake of select nutrients important for efficient wound healing and general health in a sample of older adults (64.25 ± 9.49 years of age) with chronic venous leg ulcers (CVLUs; N = 12), compared to recommended dietary allowances (RDA). Anthropometric data were also collected. Compared to RDA, participants on average consumed lower vitamin C (60.03 ± 49.73 mg/d) and higher sodium (3197.07 ± 1455.04 mg/d), sugar (181.21 ± 115.45 g/d), and saturated fat (33.75 ± 1.06 g/d). They also demonstrated a relatively high plasma n-6/n-3 polyunsaturated fatty acid ratio, a biomarker of inflammation (11.25 ± 1.99). The mean body mass index indicated extreme obesity (41.48 ± 11.47). A multidisciplinary treatment approach that includes routine dietary assessments followed by tailored dietary interventions may improve wound healing and long-term health outcomes in this population. PMID:26141998

  2. Venous thrombosis: an overview

    International Nuclear Information System (INIS)

    Venous thromboembolic disease contributes to morbidity and mortality in certain groups of hospitalized patients, particularly those who have undergone surgery. Although principles of treatment have changed relatively little during the past 20 years, significant advances have been made in the diagnosis of deep vein thrombosis (DVT). Venography, once the only reliable diagnostic technique, has been largely replaced by noninvasive tests: impedance plethysmography, venous Doppler, 125I-radiofibrinogen-uptake test, and phleborheography. Virchow's triad of stasis, vessel injury, and hypercoagulability remains a valid explanation of the pathogenesis of thrombus formation, but laboratory and clinical data have refined our knowledge of how these factors interact to result in clinically significant disease. Knowledge of the natural history of venous thrombosis, plus heightened awareness of the long-term morbidity and expense associated with the postphlebitic syndrome, have led to increased interest in preventing DVT. Clinically and economically, venous thrombosis is best managed by prevention. 61 references

  3. Microbubble mediated thrombus dissolution with diagnostic ultrasound for the treatment of chronic venous thrombi.

    Directory of Open Access Journals (Sweden)

    Shelby Kutty

    Full Text Available BACKGROUND: Central venous catheter (CVC thrombi result in significant morbidity in children, and currently available treatments are associated with significant risk. We sought to investigate the therapeutic efficacy of microbubble (MB enhanced sonothrombolysis for aged CVC associated thrombi in vivo. METHODS AND RESULTS: A model of chronic indwelling CVC in the low superior vena cava with thrombus in situ was established after feasibility and safety testing in 7 pigs; and subsequently applied for repeated, sonothrombolytic treatments in 9 pigs (total 24 treatments. Baseline intracardiac echocardiography (ICE, 10.5F, Siemens, fluoroscopy and saline flushing confirmed the absence of any pre-existing CVC thrombus. A thrombus was then allowed to form and age over 24 hours. The created thrombus was localized and measured by ICE, and transthoracic image guided high mechanical index (MI two-dimensional US treatments (1.1-1.7 MI; iE33, Philips applied intermittently whenever intravenously infused MBs (3% MRX-801; NuVox were visualized near the thrombus (n = 10; Group A. Control pigs (n = 10; Group B received US without MB. All treatments were randomized. Post-treatment thrombus area by ICE planimetry was compared with pre-treatment measurements. Thrombus area measurements before and after treatment were 0.22 and 0.10 cm(2 respectively in Group A; compared to 0.24 and 0.21 cm(2 in Group B (p  = 0.0003. Effectiveness of longer duration US and MB thrombolytic treatments were studied (n = 4, which suggested that near complete thrombus dissolution is possible. No pulmonary emboli, alterations in oxygen saturation, or hemodynamics occurred with either treatment. CONCLUSIONS: Guided high MI diagnostic US+systemic MB facilitates reduction of aged CVC associated thrombi in vivo. MB enhanced sonothrombolytic therapy may be a non-invasive safe alternative to thrombolytic agents in treating thrombotic CVC occlusions.

  4. Microcirculation of chronic venous disease: Role of leucocyte-endothelial activation and effects of pharmacological intervention.

    OpenAIRE

    Howlader, M. H.

    2004-01-01

    Many theories have been advanced to explain the development of venous ulceration in the lower limb. In recent years, the hypothesis of inappropriate leucocyte activation with the release of free radicals causing damage to the microcirculation in patients with CVD has gained popularity. No drug has so far been found to ameliorate these effects. In this thesis I have investigated a series of inflammatory markers in patients with various CEAP stages of venous disease. The aim was to asses which,...

  5. Statins improve the resolution of established murine venous thrombosis

    DEFF Research Database (Denmark)

    Kessinger, Chase W; Kim, Jin Won; Henke, Peter K;

    2015-01-01

    significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi) compared similarly to the......-lipid-lowering agents with anti-thrombotic and anti-inflammatory properties-in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice). Treatment of mice with daily atorvastatin or rosuvastatin...... therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1), tissue factor, neutrophils, myeloperoxidase, neutrophil...

  6. Idiopathic venous thromboembolism and thrombophilia

    OpenAIRE

    Sinescu, C; Hostiuc, M; Bartos, D.

    2011-01-01

    During the past decade idiopathic venous thromboembolism has become a separate entity, a chronic illness which has required prolonged anticoagulation and other prevention strategies to avoid recurrences. This article reviews recent developments regarding unprovoked venous thromboembolism and its relation with thrombophilia. In the beginning, the latest definition of idiopathic venous thromboembolism is presented. The article continues with statistics about thrombophilia, related venous thromb...

  7. Isolamento e perfil de suscetibilidade de bactérias de pé diabético e úlcera de estase venosa de pacientes admitidos no pronto-socorro do principal hospital universitário do estado de Goiás, Brasil Isolation and susceptibility profile of bacteria in diabetic foot and venous stasis ulcer of patients admitted to the emergency room of the main university hospital in the state of Goiás, Brazil

    Directory of Open Access Journals (Sweden)

    Ly de Freitas Fernandes

    2007-09-01

    Full Text Available CONTEXTO: Lesões infectadas de membros inferiores (úlceras diabéticas e úlceras de estase venosa são causa de grande sofrimento e incapacitação funcional com impacto social, econômico e aumento do risco de complicações severas. OBJETIVO: Caracterizar a microbiota e determinar o perfil de suscetibilidade antimicrobiana das bactérias isoladas de lesões de membros inferiores secundárias a úlcera de estase venosa e pé diabético. MÉTODOS: Foram incluídos no estudo pacientes portadores de lesões de membros inferiores, sendo diabéticos, e pacientes com úlcera de estase venosa, atendidos em um serviço de urgência de um hospital universitário de Goiânia (GO, no período de fevereiro de 2005 a agosto de 2006. A coleta de material foi realizada com swab de algodão para realização de cultura e teste de sensibilidade antimicrobiana, empregando-se técnicas preconizadas. RESULTADOS: Das amostras analisadas, foi detectada a presença de bactérias em 88,46%. Os cocos gram-positivos foram caracterizados como Staphylococcus aureus e Staphylococcus epidermidis. Dentre os bastonetes gram-negativos, detectou-se Pseudomonas aeruginosa,Escherichia coli,Proteus mirabilis e Enterobacter sp. CONCLUSÕES: Os microrganismos isolados das lesões de membros inferiores (pé diabético e úlcera de estase venosa incluíram bactérias gram-positivas e negativas, sendo Staphylococcus aureus,Pseudomonas aeruginosa e Escherichia coli as mais freqüentes, com elevada resistência a diversos antimicrobianos.BACKGROUND: Infected lower limb injuries (diabetic ulcers and venous stasis ulcers cause great suffering and functional disability with social and economic impact and increase in risk of severe complications. OBJECTIVE: To characterize the microbiota and determine the antimicrobial susceptibility profile of isolated bacteria in lower limb injuries secondary to the venous stasis ulcer and diabetic foot. METHODS: Patients with lower limb lesions were

  8. A prospective, descriptive study of hour-to-hour and day-to-day temperature variability of skin affected by chronic venous disorders.

    Science.gov (United States)

    Kelechi, Teresa J; McNeil, Rebecca B

    2008-04-01

    Evidence suggests that skin temperature is elevated in the lower legs of individuals with the most severe stages of chronic venous disorder-related skin inflammation. Fifteen (15) patients (average age 67.7 years) with several chronic health conditions, chronic venous disorders, and a history of leg ulcers volunteered to participate in a prospective, descriptive, two-part (hourly and daily) study to test two hypotheses: 1) that skin temperature variations of chronically inflamed skin of lower legs affected by chronic venous disorders exhibit no differences in hour-to-hour and day-to-day rhythmic patterns associated with sleep and activities such as walking, exercise, or compression stocking use among four selected skin sites (two per leg) or between the legs of individuals with chronic venous disorders; and 2) that the difference in temperature between sites is unequal between legs. All study participants were at high risk for developing venous ulcers (CEAP stage 4 and 5). Skin temperature was obtained at sites with highest temperatures and/or areas of healed ulcers and mapped hourly over a 2-day period with a data logger and daily for 30 days with an infrared thermometer. No consistent, visually detectable effects due to caffeine use, eating, activity, or other variables assessed were found; only sleeping resulted in a consistent increase in skin temperature. Difference in skin temperature between measurement sites was found to be dependent on the leg on which the sites were located (P=0.1127). Because skin temperature variability could not be explained by the variables assessed, a temperature change could suggest the presence of a pathological process such as an infection or increased inflammation. Future studies to determine whether variability of skin temperature over sites affected by chronic venous disorders heralds further skin impairment are warranted. PMID:18480503

  9. Comparison of the Complications of Central Vein Catheters and Arterio-Venous Fistulae in Children on Chronic Hemodialysis

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    F Ghane Sherbaf

    2006-08-01

    Full Text Available Background: Complications related to vascular access are among the most important causes of morbidity in children chronically on hemodialysis. This study was designed to determine the prevalence of the central vein catheters (CVC and arterio-venous fistulae (AVF in children on chronic hemodialysis. Methods: This study includes 68 children who have been treated with hemodialysis in Dr. Sheikh Hospital, Mashhad, Iran, during 2000-2005. Physical examination, clinical and paraclinical findings were recorded in special charts. Findings: Out of 68 patients treated with hemodialysis 29 (42.6% were female and 39 (57.3% male. The average duration time of hemodialysis was 15.8 months. Before performing AVF, the central venous catheters were placed in subclavian vein in 28 patients (41.1% and internal jugular vein in 26 patients (38.2%. The fistula placed was radio-cephalic in 29 (42.6% and brachio-basilic in 33 children (48.5%. 48 patients (77.4% underwent only one surgery for AVF. The most frequent complications of central venous catheters were: catheter infection (48.1%, inadvertent extraction of the catheters (7.4%, cardiac arrhythmia (1.8% and hemothorax (1.8%. The most common complications of AVF in decreasing order of frequency were: non-functional fistula due to thrombosis or hematoma (20.9%, infection (12.9%, aneurysms (11.2% and ischemia of the hand presenting as paresthesia, dysesthesia and pain (11.2%. Overall, 10 (18.5% patients were hospitalized due to the complications of CVC and 20 (29.4% for the complications of AVF. Conclusion: The most frequently observed complications of CVC and AVF were catheter infection and non-functional fistula. The risk factors for AVF dysfunction were young age, hypotension and hemodialysis without administration of heparin.

  10. Elimination of axial venous reflux

    OpenAIRE

    Oinonen, Annamari

    2009-01-01

    Chronic venous disease (CVD), including uncomplicated varicose veins and chronic venous insufficiency, is one of the most common medical conditions in the Western world. The central feature of CVD is venous reflux, which may be primary, congenital, or result from an antecedent event, usually an acute deep venous thrombosis (DVT). When the history of DVT is clear, the clinical manifestations of secondary CVD are commonly referred to as the post-thrombotic syndrome. Regardless of the underlying...

  11. Korean Studies on Blood Stasis: An Overview

    Directory of Open Access Journals (Sweden)

    Bongki Park

    2015-01-01

    Full Text Available Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews, 52 were clinical studies, and 140 were preclinical articles. “Stagnant blood within the body” was the most frequently mentioned phrase of the traditional concept of blood stasis. Traumatic injury was the most frequently studied disease/condition in the clinical studies. In the preclinical studies, coagulopathy was studied most frequently, followed by hyperviscosity, hyperlipidemia, inflammation, neoplasm, ischemic brain injury, and atherosclerosis. Hyeolbuchukeo-tang and Angelicae Gigantis Radix were the most frequent formula and single herb, respectively, used in the blood stasis researches. The results showed that blood stasis was mainly recognized as disorder of circulation and many studies showed the effectiveness of activating blood circulating herbs for diseases and pathologies such as traumatic injury or coagulopathy. Further studies are needed in the pathologic mechanisms and various diseases of blood stasis.

  12. Progressive or degressive compression pressure profile in patients with chronic venous disorders of the lower limb

    Directory of Open Access Journals (Sweden)

    Giovanni Mosti

    2014-03-01

    Full Text Available Graduated compression devices are considered the standard care for management of venous and lymphatic disorders. Recently compression devices exerting a pressure over the calf higher than over the ankle have been proved to be more effective than traditional graduated devices in increasing the impaired ejection fraction (EF from the lower leg in patients with venous disease. Aim of this work is presenting an overview of the new concept on progressive compression, its potential benefits and limits. In different series of tests, the EF from the lower leg was assessed in 70 patients with severe reflux in the great saphenous vein (GSV. EF was measured by strain gauge plethysmography, in baseline conditions and after applying graduated compression devices or the new inversely graduated or progressive compression (PC devices. The interface pressure was recorded, simultaneously with the EF, both in the gaiter area (B1 point and at the calf (C point in order to assess the compression pressure profile. EF, severely impaired in patients with GSV reflux, was increased by compression. So called PC devices (both PC elastic stocking and PC inelastic bandages were significantly more effective than graduated compression in increasing the ejection fraction. The higher the pressure on the calf the higher the EF improvement. Maintaining the same strong pressure over the calf by means of two progressive stockings and increasing the pressure only over the calf to restore a graduated compression didn’t improve the EF. To improve venous pumping function in the ambulant patient stronger compression of the calf is more effective than graduated compression. This can be explained by the higher amount of blood volume pooled in the calf veins.

  13. Low level laser therapy (GaAlInP 660 nm) in healing of a chronic venous ulcer: a case study

    Science.gov (United States)

    Botaro, C. A.; Faria, L. A.; Oliveira, R. G.; Bruno, R. X.; Rocha, C. A. Q. C.; Paiva-Oliveira, E. L.

    2015-07-01

    The venous ulcer represents approximately 70% to 90% of inferior member ulcers, and the most common etiological factor is venous insufficiency, triggered by venous hypertension. Currently in Brazil there are several types of lasers used in physiotherapy, which benefit biological potential, emitting low power radiation, with anti-inflammatory, analgesic, healing and circulatory effects. This study aimed at the analysis of low level laser therapy effects (LLLT) on the process of tissue repair in chronic venous ulcers. We conducted a case study of a patient with a venous ulcer in the lateral region of the right inferior member. The patient underwent LLLT, which used a GaAlInP diode laser, with a wavelength of 660 nm and energy density of 4 J cm-2 applied punctually at the edges of the wound, with an average distance of 1 cm between the points with a pen-laser perpendicular wrapped in paper and a plastic wrap, keeping contact with the tissue. After four months of therapy and a total of 21 sessions, an improvement was noticeable in the gross appearance of the wound, but after a month and a half without therapy, the dimensions of the wound increased in length and width. Analyzing the results of this case study allows us to conclude that the LLLT GaAlInP (660 nm) with an energy density of 4 J cm-2, was not successful in the healing of venous ulcers.

  14. A RARE CASE ON CHRONIC BUDD- CHIARI SYNDROME

    Directory of Open Access Journals (Sweden)

    Balaji

    2013-04-01

    Full Text Available ABSTRACT: Budd–Chiari syndrome is the clinical picture caused by occlusion of the hepatic veins. It presents with the abdominal pain, ascites a nd hepatomegaly. The syndrome can be fulminant, acute, chronic, or asymptomatic. One such middle aged female patient came to the clinic with history of chronic jaundice, ascites, a nd hyper pigmentation of both legs. After complete physical examination and investigations, the reports revealed membranous web causing obstruction of inferior vena cava resulting in venous stasis of the Lower limbs and in turn the hepatic veins has resulted in esophageal va rices with early liver cell necrosis and jaundice.

  15. The Score Model Containing Chinese Medicine Syndrome Element of Blood Stasis Presented a Better Performance Compared to APRI and FIB-4 in Diagnosing Advanced Fibrosis in Patients with Chronic Hepatitis B

    Directory of Open Access Journals (Sweden)

    Xiao-Ling Chi

    2016-01-01

    Full Text Available This study aims to explore a useful noninvasive assessment containing TCM syndrome elements for liver fibrosis in CHB patients. The demographic, clinical, and pathological data were retrospectively collected from 709 CHB patients who had ALT less than 2 times the upper limit of normal from April 2009 to October 2012. Logistical regression and area under receiver-operator curve (AUROC were used to determine the diagnostic performances of simple tests for advanced fibrosis (Scheuer stage, F ≥ 3. Results showed that the most common TCM syndrome element observed in this CHB population was dampness and Qi stagnation, followed by blood stasis, by heat, and less by Qi deficiency and Yin deficiency. The logistical regression analysis identified AST ≥ 35 IU/L, PLT ≤ 161 × 109/L, and TCM syndrome element of blood stasis as the independent risk factors for advanced fibrosis. Therefore, a score model containing these three factors was established and tested. The score model containing blood stasis resulted in a higher AUC (AUC = 0.936 compared with APRI (AUC = 0.731 and FIB-4 (AUC = 0.709. The study suggested that the score model containing TCM syndrome element of blood stasis could be used as a useful diagnostic tool for advanced fibrosis in CHB patients and presented a better performance compared to APRI and FIB-4.

  16. The Score Model Containing Chinese Medicine Syndrome Element of Blood Stasis Presented a Better Performance Compared to APRI and FIB-4 in Diagnosing Advanced Fibrosis in Patients with Chronic Hepatitis B.

    Science.gov (United States)

    Chi, Xiao-Ling; Shi, Mei-Jie; Xiao, Huan-Ming; Xie, Yu-Bao; Cai, Gao-Shu

    2016-01-01

    This study aims to explore a useful noninvasive assessment containing TCM syndrome elements for liver fibrosis in CHB patients. The demographic, clinical, and pathological data were retrospectively collected from 709 CHB patients who had ALT less than 2 times the upper limit of normal from April 2009 to October 2012. Logistical regression and area under receiver-operator curve (AUROC) were used to determine the diagnostic performances of simple tests for advanced fibrosis (Scheuer stage, F ≥ 3). Results showed that the most common TCM syndrome element observed in this CHB population was dampness and Qi stagnation, followed by blood stasis, by heat, and less by Qi deficiency and Yin deficiency. The logistical regression analysis identified AST ≥ 35 IU/L, PLT ≤ 161 × 10(9)/L, and TCM syndrome element of blood stasis as the independent risk factors for advanced fibrosis. Therefore, a score model containing these three factors was established and tested. The score model containing blood stasis resulted in a higher AUC (AUC = 0.936) compared with APRI (AUC = 0.731) and FIB-4 (AUC = 0.709). The study suggested that the score model containing TCM syndrome element of blood stasis could be used as a useful diagnostic tool for advanced fibrosis in CHB patients and presented a better performance compared to APRI and FIB-4. PMID:26904141

  17. Influence of Pneumoperitoneum on the Deep Venous System during Laparoscopy

    OpenAIRE

    Wazz, Gabi; Branicki, Frank; Taji, Hakam; Chishty, Imran

    2000-01-01

    Background: There is widespread concern that laparoscopic procedures that are usually performed under general anesthesia, using muscle relaxation, in a reverse Trendelenberg position and with pneumoperitoneum, may lead to venous stasis in lower limbs. Objective: To evaluate perioperative changes in the venous system and determine the frequency of deep venous thrombosis associated with minimally invasive surgery. Design: Prospective consecutive series. Subjects: Sixty-five patients undergoing ...

  18. Rational therapy of chronic venous insufficiency – chances and limits of the therapeutic use of horse-chestnut seeds extract

    Directory of Open Access Journals (Sweden)

    Greeske Karin

    2001-12-01

    Full Text Available Abstract Background and methods We report two clinical studies, one already published, performed in patients with early and advanced chronic venous insufficiency (CVI. In both, compression therapy and oral therapy with horse-chestnut seeds extracts (HCSE were compared to placebo. Results The published study in early CVI (Grade I showed HCSE and compression to be superior to placebo and to be equivalent to each other in reducing lower leg volume, a measure for oedema. In the study, in advanced CVI (Grade II and IIIa, compression appeared to be superior to placebo, whereas HCSE was not. HCSE fared better in Grade II than in Grade IIIa patients. These results are discussed in the light of data from an in vitro model, where HCSE has been able to close the intercellular gaps in the venular endothelium. Not fully specified factors lead to an opening of these gaps, resulting in oedema as well as in local coagulation and thrombosis. The subsequent inflammation keeps these gaps open and initiates and maintains a chronic disease process, which may be the starting point of CVI. Conclusion Due to its ability to close the venular endothelial gaps, HCSE seems to be a suitable and protecting therapy during the early stages of CVI. In later more severe stages compression therapy is indicated. Taking into account the observed negative impact of compression on quality of life, pharmacological CVI therapy should start early to avoid progress and to spare patients compression therapy.

  19. Predicted burden of venous disease.

    Science.gov (United States)

    Onida, Sarah; Davies, Alun Huw

    2016-03-01

    Chronic venous disease is a common condition with clinical signs and symptoms ranging from spider veins, to varicose veins, to active venous ulceration. Both superficial and deep venous dysfunction may be implicated in the development of this disease. Socio-economic factors are shaping our population, with increasing age and body mass index resulting in significant pressure on healthcare systems worldwide. These risk factors also lead to an increased risk of developing superficial and/or deep venous insufficiency, increasing disease prevalence and morbidity. In this chapter, the authors review the current and future burden of chronic venous disease from an epidemiological, quality of life and economic perspective. PMID:26916773

  20. Diagnosis of venous disorders

    International Nuclear Information System (INIS)

    Limited accuracy in the clinic diagnosis of deep vein thrombosis (VT) makes such diagnostic tests such as duplex sonography or venography necessary. Exact information on the age and extent of the thrombus are necessary for the clinician to optimize the therapeutric management. The correct diagnosis of calf vein thrombosis and of recurrent VT in patients with postphlebitis changes also has implications for treatment. After exclusion of thrombosis, the radiologist should evaluate the leg for other possible causes of symptoms besides VT. Investigation of the venous sytem also has a role in the diagnosis in patients with suspected pulmonary embolism. In patients with chronic venous insuffficiency the deep venous system should assessed for patency and venous valve function. The superficial veins should be differentiated in segments with sufficient or insufficient venous valves, and it is also necessary to look for insufficiency of the perforrating veins. In patients with superficial phlebitis there is risk of propagation into the deep venous system. (orig.)

  1. Endovascular Thrombolysis Using Monteplase for Non-chronic Deep Venous Thrombosis

    International Nuclear Information System (INIS)

    This study was designed to evaluate the usefulness of endovascular thrombolysis using monteplase for deep venous thrombosis (DVT). Between December 2005 and October 2009, at our institution nine endovascular thrombolysis treatments with monteplase were performed for symptomatic DVT in eight patients (6 women, 2 men; mean age, 56 (range, 15-80) years). In all, systemic anticoagulation administered by the peripheral intravenous route with heparin and/or thrombolysis with urokinase followed by anticoagulation with orally administered warfarin had been performed, and subsequently six endovascular treatments without monteplase were administered. However, DVT persisted, and endovascular treatments with monteplase were tried. In six (67%) of the nine procedures, DVT completely or almost completely disappeared after endovascular thrombolysis with monteplase. Mean dose of monteplase used was 2,170,000 IU. There was only one procedure-related complication. In one patient, just after thrombolysis with monteplase, bleeding at the puncture site and gingival bleeding occurred. Bleeding was stopped by manual astriction only. Endovascular thrombolysis with monteplase may be an effective treatment for DVT, even in cases resistant to traditional systemic anticoagulation and thrombolysis and endovascular procedures without monteplase.

  2. Minimally Invasive Monitoring of Chronic Central Venous Catheter Patency in Mice Using Digital Subtraction Angiography (DSA)

    OpenAIRE

    Figueiredo, Giovanna; Fiebig, Teresa; Kirschner, Stefanie; Nikoubashman, Omid; Kabelitz, Lisa; Othman, Ahmed; Nonn, Andrea; Kramer, Martin; Brockmann, Marc A.

    2015-01-01

    Background Repetitive administration of medication or contrast agents is frequently performed in mice. The introduction of vascular access mini-ports (VAMP) for mice allows long-term vascular catheterization, hereby eliminating the need for repeated vessel puncture. With catheter occlusion being the most commonly reported complication of chronic jugular vein catheterization, we tested whether digital subtraction angiography (DSA) can be utilized to evaluate VAMP patency in mice. Methods Twent...

  3. A new cyclodextrin-grafted viscose loaded with aescin formulations for a cosmeto-textile approach to chronic venous insufficiency.

    Science.gov (United States)

    Cravotto, G; Beltramo, L; Sapino, S; Binello, A; Carlotti, M E

    2011-10-01

    Cosmeto-textile applications can be used in the treatment of chronic venous insufficiency in legs by means of elastic bandages loaded with natural products which possess flebotonic properties. We have developed an efficient synthetic procedure for the preparation of β-cyclodextrin (β-CD)-grafted viscose by means of a 2-step ultrasound-assisted reaction. The highly grafted fabric bearing bis-urethane bridged β-CD has been characterized by ATR-FTIR and CP-MAS spectra and by an empiric colorimetric method which used phenolphthalein as the CD guest. We have also developed a suitable cosmetic preparation containing natural substances and extracts (aescin, menthol, Centella asiatica and Ginkgo biloba) to recharge the CD-grafted textile. The efficacy of the new cosmeto-textile has been corroborated by in vitro studies of diffusion through membranes, cutaneous permeation and accumulation in porcine skin. Aescin was taken as a reference compound and its concentration in the different compartments was monitored by HPLC analysis. This cost effective cosmeto-textile shows excellent application compliance and is easily recharged and so has the strong base characteristics needed for possible industrial production. PMID:21805331

  4. Experimental Researches of Blood Stasis and Aging

    Institute of Scientific and Technical Information of China (English)

    王传社; 李顺成; 马治中; 李志新; 蒋文跃

    2001-01-01

    @@It was reported by most physicians of traditional Chinese medicine (TCM) in past dynasties that Deficiency of Zangfu(脏腑), Qi and blood, especially the Kidney deficiency, is closely related with aging, and Chinese drugs for fortifying Kidney also play a main role in anti-aging. Many scholars have recently studied the relationship between aging and the Excess Syndrome, such as blood stasis, stagnation of Phlegm Turbidity and stagnation of Qi, particularly the relationship between blood stasis and aging.

  5. Non-invasive evaluation of the coronary venous system in patients with chronic systolic heart failure by 64-detector computed tomography

    International Nuclear Information System (INIS)

    Background: Imaging coronary venous systems to guide transcatheter cardiac interventions are becoming increasingly important, particularly in heart failure patients who are selected for cardiac resynchronization therapy (CRT). Failure of left ventricular (LV) lead placement during the procedure has been attributed to the inability to insert catheters into the coronary sinus and the lack of suitable side branches. Purpose To comparatively assess the value of a 64-detector MDCT examination in visualizing the cardiac veins and evaluating the morphological characteristics of the coronary venous system in patients with and without chronic systolic heart failure (SHF). Material and Methods A 64-detector MDCT examination of the heart was performed in 26 consecutive patients (five women, 21 men; mean age 57.80 ± 12.05 years; range 27-81 years) with chronic SHF. The morphological characteristics of the coronary venous system, such as the diameter, the distances between the venous tributaries, the angle and the tortuosity, were evaluated. The group was compared with a subgroup of 52 subjects without SHF (LV ejection fraction >40%) matched for age, sex, and the risk factors for coronary artery disease. Results: The coronary sinus (CS), great cardiac vein (GCV), anterior interventricular vein (AIV), and posterior interventricular vein (PIV) were visualized in all 78 individuals. The posterior vein of the left ventricle (PVLV) (63/78), left marginal vein (LMV) (72/78), and the small cardiac vein (SCV) (50/78) were visualized in SHF and control patients (p = NS). The lengths between venous tributaries were higher (p > 0.05) and more dilated (P < 0.001 for CS, GCV, AIV, PVLV, LMV; p = 0.001 for PIV) in the cases with SHF compared with the control population. The angle between the CS-GCV axis and the venous branches was wider (p = 0.02 for LMV and PIV, p = 0.001 for PVLV) and did not have any correlation with the LV diameter in cases with SHF. There was no difference between the

  6. Clinical Study on Abdominal Acupuncture plus Herbal Medicine for Chronic Pelvic Pain Due to Qi Stagnation and Blood Stasis%腹针配合中药治疗气滞血瘀型慢性盆腔痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋玉娟; 张殿全; 苏丹萍

    2015-01-01

    Objective To observe the clinical efficacy of abdominal acupuncture plus herbal medicine in treating chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.Method Sixty patients with chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by abdominal acupuncture plus herbal medicine, while the control group was by herbal medicine alone. After 3 menstrual cycles, the Visual Analogue Scale (VAS) for abdominal pain and McCormack scale were observed.Result After intervention, the abdominal VAS score and McCormack score were changed significantly in both groups (P<0.01,P<0.05). After intervention, there were significant differences in comparing the VAS score and McCormack score between the two groups (P<0.01).Conclusion Abdominal acupuncture plus herbal medicine can reduce chronic pelvic pain due to qi stagnation and blood stasis after pelvic inflammatory diseases.%目的:观察腹针配合中药治疗盆腔炎性疾病后气滞血瘀型慢性盆腔痛的临床疗效。方法将60例盆腔炎性疾病后气滞血瘀型慢性盆腔痛患者随机分为治疗组和对照组,每组30例。治疗组采用腹针配合中药治疗,对照组采用单纯中药治疗。治疗3个月经周期后,观察两组治疗前后腹痛VAS评分及McCormack量表评分变化。结果两组治疗后腹痛VAS评分及McCormack量表评分与同组治疗前比较,差异均具有统计学意义(P<0.01,P<0.05)。治疗组治疗后腹痛VAS评分及McCormack量表评分与对照组比较,差异均具有统计学意义(P<0.01)。结论腹针配合中药能够减轻盆腔炎性疾病后气滞血瘀型慢性盆腔痛。

  7. Proliferation and mitogenic response to PDGF-BB of fibroblasts isolated from chronic venous leg ulcers is ulcer-age dependent

    DEFF Research Database (Denmark)

    Agren, M S; Steenfos, H H; Dabelsteen, S;

    1999-01-01

    pronounced than would have been expected based on studies on acute wounds. The objective of this study was to compare fibroblasts in culture obtained from chronic wounds (non-healing chronic venous leg ulcers), acute wounds and normal dermis regarding growth, mitogenic response to platelet-derived growth...... fibroblasts (n = 8) was significantly (p < 0.05) decreased compared with those from acute wounds (n = 10) and normal dermis (n = 5). Fibroblasts from ulcers older than 3 y grew significantly (p < 0.01) slower than those from ulcers that had been present for less than 3 y. Morphology and size of fibroblasts...... from the oldest chronic wounds deviated substantially from those of acute wounds and normal dermis, and resembled in vitro aged or senescent fibroblasts. Mitogenic response of chronic wound fibroblasts to human recombinant platelet-derived growth factor-BB was also reduced with ulcer age. No...

  8. 'Chronic cerebrospinal venous insufficiency' in multiple sclerosis. Is multiple sclerosis a disease of the cerebrospinal venous outflow system?; 'Chronische zerebrospinale venoese Insuffizienz' bei Multipler Sklerose. Ist die Multiple Sklerose eine Erkrankung des zerebrospinalen venoesen Abflusssystems?

    Energy Technology Data Exchange (ETDEWEB)

    Wattjes, M.P. [VU Univ. Medical Center, Amsterdam (Netherlands). Dept. of Radiology; Doepp, F. [Universitaetsklinik Charite, Berlin (Germany). Neurologische Klinik; Bendszus, M. [Heidelberg Univ. (Germany). Abt. fuer Neuroradiologie; Fiehler, J. [Universitaetsklinikum Hamburg-Eppendorf (Germany). Klinik fuer Neuroradiologische Diagnostik und Intervention

    2011-06-15

    Chronic impaired venous outflow from the central nervous system has recently been claimed to be associated with multiple sclerosis (MS) pathology. This resulted in the term chronic cerebrospinal venous insufficiency (CCSVI) in MS. The concept of CCSVI is based on sonography studies showing that impaired venous outflow leading to pathological reflux is almost exclusively present in MS patients but not in healthy controls. Based on these findings, a new pathophysiological concept has been introduced suggesting that chronic venous outflow obstruction and venous reflux in the CNS result in pathological iron depositions leading to inflammation and neurodegeneration. The theory of CCSVI in MS has rapidly generated tremendous interest in the media and among patients and the scientific community. In particular, the potential shift in treatment concepts possibly leading to an interventional treatment approach including balloon angioplasty and venous stent placement is currently being debated. However, results from recent studies involving several imaging modalities have raised substantial concerns regarding the CCSVI concept in MS. In this review article, we explain the concept of CCSVI in MS and discuss this hypothesis in the context of MS pathophysiology and imaging studies which have tried to reproduce or refute this theory. In addition, we draw some major conclusions focusing in particular on the crucial question as to whether interventional treatment options are expedient. In conclusion, the present conclusive data confuting the theory of CCSVI in MS should lead to reluctance with respect to the interventional treatment of possible venous anomalies in MS patients. (orig.)

  9. Itch, pain, and burning sensation are common symptoms in mild to moderate chronic venous insufficiency with an impact on quality of life.

    Science.gov (United States)

    Duque, Maria I; Yosipovitch, Gil; Chan, Yiong Huak; Smith, Ronald; Levy, Pavel

    2005-09-01

    To our knowledge there are no studies evaluating the prevalence and characteristics of itch, pain, and burning sensation among patients with mild to moderate chronic venous insufficiency or assessing the impact of these symptoms on quality of life. In this report 100 patients met the inclusion criteria. Patients who suffered from itch were also assessed with the use of a validated questionnaire and a modified Skindex-16 questionnaire. We found that the prevalence of itch was 66%. Concomitant itch and burning sensation as well as itch and pain were noted in 47% and 44% of the patients, respectively. No correlation was noted between the severity of these symptoms and the degree of venous insufficiency. Itch had a negative impact on quality of life. A limitation of this study is that the participants, who were primarily hospital employees, are more likely to develop these symptoms. Therefore this study does not reflect the true prevalence of these symptoms in the general population. This study found that itch, pain, and burning sensation are common symptoms of mild to moderate chronic venous insufficiency with a significant impact on quality of life. PMID:16112363

  10. Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism.

    Science.gov (United States)

    Poli, Daniela; Grifoni, Elisa; Antonucci, Emilia; Arcangeli, Chiara; Prisco, Domenico; Abbate, Rosanna; Miniati, Massimo

    2010-10-01

    After a first episode of pulmonary embolism (PE), two major problems need to be considered: risk of recurrence when anticoagulation is stopped, and risk of chronic thromboembolic pulmonary hypertension (CTPH). We followed prospectively consecutive patients who survived a first episode of PE, with or without deep vein thrombosis, to assess the incidence of venous thromboembolism (VTE) recurrences and of symptomatic and asymptomatic CTPH. After 3-6 months of oral anticoagulant therapy (OAT) patients underwent transthoracic echocardiography for measuring transtricuspid (rV-rA) gradient. When rV-rA gradient was >35 mmHg further evaluations were performed to rule in or out CTPH. During follow-up patients who developed persistent dyspnea were re-evaluated. In patients who underwent OAT withdrawal D-dimer (DD), prothrombin fragment 1 + 2 (F1 + 2), and thrombophilia were evaluated one month after warfarin discontinuation. Overall, 239 patients, 118 males, median age 59(16-89) years, were followed up for a median time of 36(9-192) months. Nine patients had rV-rA gradient >30 mmHg and ≤35 mmHg, and one of 37 mmHg. Among patients with normal rV-rA gradient, one developed persistent dyspnea 55 months after the first event and CPTH was confirmed. Among 206 patients who stopped OAT, 23(11.2%) had VTE recurrence, 11 PE(48%). Elevated DD and F1 + 2 levels after stopping OAT were significantly associated with recurrence. None of patients with recurrent VTE had elevated rV-rA gradient. In our series the incidence of CTPH after a first episode of PE was 0.4%. VTE recurrence and elevated DD and F1 + 2 levels seemed not to be related to the development of CTPH. PMID:20157841

  11. Inhibitory Effect of Natural Anti-Inflammatory Compounds on Cytokines Released by Chronic Venous Disease Patient-Derived Endothelial Cells

    Directory of Open Access Journals (Sweden)

    Veronica Tisato

    2013-01-01

    Full Text Available Large vein endothelium plays important roles in clinical diseases such as chronic venous disease (CVD and thrombosis; thus to characterize CVD vein endothelial cells (VEC has a strategic role in identifying specific therapeutic targets. On these bases we evaluated the effect of the natural anti-inflammatory compounds α-Lipoic acid and Ginkgoselect phytosome on cytokines/chemokines released by CVD patient-derived VEC. For this purpose, we characterized the levels of a panel of cytokines/chemokines (n=31 in CVD patients’ plasma compared to healthy controls and their release by VEC purified from the same patients, in unstimulated and TNF-α stimulated conditions. Among the cytokines/chemokines released by VEC, which recapitulated the systemic profile (IL-8, TNF-α, GM-CSF, INF-α2, G-CSF, MIP-1β, VEGF, EGF, Eotaxin, MCP-1, CXCL10, PDGF, and RANTES, we identified those targeted by ex vivo treatment with α-Lipoic acid and/or Ginkgoselect phytosome (GM-CSF, G-CSF, CXCL10, PDGF, and RANTES. Finally, by investigating the intracellular pathways involved in promoting the VEC release of cytokines/chemokines, which are targeted by natural anti-inflammatory compounds, we documented that α-Lipoic acid significantly counteracted TNF-α-induced NF-κB and p38/MAPK activation while the effects of Ginkgo biloba appeared to be predominantly mediated by Akt. Our data provide new insights into the molecular mechanisms of CVD pathogenesis, highlighting new potential therapeutic targets.

  12. Medical management of venous ulcers.

    Science.gov (United States)

    Pascarella, Luigi; Shortell, Cynthia K

    2015-03-01

    Venous disease is the most common cause of chronic leg ulceration and represents an advanced clinical manifestation of venous insufficiency. Due to their frequency and chronicity, venous ulcers have a high socioeconomic impact, with treatment costs accounting for 1% of the health care budget in Western countries. The evaluation of patients with venous ulcers should include a thorough medical history for prior deep venous thrombosis, assessment for an hypercoagulable state, and a physical examination. Use of the CEAP (clinical, etiology, anatomy, pathophysiology) Classification System and the revised Venous Clinical Severity Scoring System is strongly recommended to characterize disease severity and assess response to treatment. This venous condition requires lifestyle modification, with affected individuals performing daily intervals of leg elevation to control edema; use of elastic compression garments; and moderate physical activity, such as walking wearing below-knee elastic stockings. Meticulous skin care, treatment of dermatitis, and prompt treatment of cellulitis are important aspects of medical management. The pharmacology of chronic venous insufficiency and venous ulcers include essentially two medications: pentoxifylline and phlebotropic agents. The micronized purified flavonoid fraction is an effective adjunct to compression therapy in patients with large, chronic ulceration. PMID:26358306

  13. Influence of antioxidant complex on the adhesion of leukocytes in chronic venous insufficiency of lower limbs in rats

    Directory of Open Access Journals (Sweden)

    Mark Plotnikov

    2012-01-01

    Conclusions: Model of CVI of lower limb is accompanied by increased venous pressure and raised adhesion activity of leukocytes. Administration of AOC for 14 days reduces the adhesive activity of leukocytes.

  14. Basic Mechanisms and Pathogenesis of Venous Thrombosis

    OpenAIRE

    Esmon, Charles T

    2009-01-01

    In 1856 Virchow proposed a triad of causes for venous thrombosis, postulating that stasis, changes in the vessel wall or changes in the blood could lead to thrombosis. We now know that abnormally high levels of some coagulation factors and defects in the natural anticoagulants contribute to thrombotic risk. Among these, factor V Leiden, which renders factor Va resistant to activated protein C, is the most prevalent with approximately 5% of the Caucasian population having this genetic alterati...

  15. Experimental Researches of Blood Stasis and Aging

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    It was reported by most physicians of traditional Chinese medicine (TCM) in past dynasties that Deficiency of Zangfu(脏腑), Qi and blood, especially the Kidney deficiency, is closely related with aging, and Chinese drugs for fortifying Kidney also play a main role in anti-aging. Many scholars have recently studied the relationship between aging and the Excess Syndrome, such as blood stasis, stagnation of Phlegm Turbidity and stagnation of Qi, particularly the relationship between blood stasis and aging.……

  16. Duration of wound fluid secretion from chronic venous leg ulcers is critical for interleukin-1α, interleukin-1β, interleukin-8 levels and fibroblast activation

    DEFF Research Database (Denmark)

    Zillmer, Rikke; Trøstrup, Hannah; Karlsmark, Tonny; Ifversen, Peter; Ågren, Sven Per Magnus

    2011-01-01

    retentive hydrophobic foam on the levels of prototypic cytokines [interleukin (IL)-1a, IL-1ß], a chemokine (IL-8) and proteinases [matrix metalloproteinase (MMP)-9] in 23 chronic venous leg ulcer patients. Bioactivity of 1 and 24 h wound fluids, and serum was also compared. There were no significant...... temporal changes in the levels of the above-mentioned four proteins, when comparing three consecutive 8-h intervals starting from 0800 that in turn did not differ significantly with the 24-h collection levels. IL-1a, IL-1ß and IL-8 levels were higher (p ...

  17. 咳嗽从瘀血论治经验%The experiences of the treatment on cough from blood stasis

    Institute of Scientific and Technical Information of China (English)

    马献中; 王世彪; 王保平

    2014-01-01

    Cough lung disease is one of the most common syndromes caused by many reasons, cough, a cough and internal cough points, most doctors more responsibility in the lung, spleen, liver, kidney damage, or due to feel the wind, cold, heat, dryness, fire evil and hair, or phlegm due to spleen deficiency, liver fire attacking lung, deficiency of kidney qi and other causes. In recent years, the study found, blood stasis caused one of the main causes of chronic cough, especially in chronic cough patients. Our clinical treatment of chronic bronchitis, cough asthma, pulmonary heart disease, bronchiectasis patients, each with blood stasis of TCM, often obtain good effect. The blood stasis cough experience summarized as follows.

  18. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    Directory of Open Access Journals (Sweden)

    Edel Marie Quinn

    Full Text Available BACKGROUND: Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics. OBJECTIVE: We propose utilizing mobile phone technology to decentralise care from tertiary centres to the community, improving efficiency and patient satisfaction, while maintaining patient safety. METHODS: Bespoke mobile software was developed for Apples iPhone 4 platform. This allowed for the remote collection of patient images prospectively and their transmission with clinical queries, from the primary healthcare team to the tertiary centre. Training and iPhones were provided to five public health nurses in geographically remote areas of the region. Data were uploaded securely and user end software was developed allowing the review and manipulation of images, along with two way communication between the teams. Establishing reliability, patients were reviewed clinically as well as remotely, and concordance analysed. Qualitative data were collected through focus group discussion. RESULTS: From October to December 2011 eight patients (61-83 yrs, mean 75.3 yrs with chronic venous ulceration and their five public health nurses were recruited. Data were transmitted using 3 G, Edge, GPRS and WiFi, at a mean speed of 69.03 kps. Concordance was 100% for wound bed assessment, 80% for skin integrity/colour and 60% for exudate assessment. Focus group analysis explored the concept, practicalities and future applications of the system. CONCLUSIONS: With an evolving national data network, the secure transmission of clinical images is a safe alternative to regular clinic appointments for patients with chronic venous ulceration. With further development, and packaged as a freely downloadable application, this has the potential to support the community care of chronic wounds.

  19. Cerebrospinal fluid stasis and its clinical significance.

    Science.gov (United States)

    Whedon, James M; Glassey, Donald

    2009-01-01

    We hypothesize that stasis of the cerebrospinal fluid (CSF) occurs commonly and is detrimental to health. Physiologic factors affecting the normal circulation of CSF include cardiovascular, respiratory, and vasomotor influences. The CSF maintains the electrolytic environment of the central nervous system (CNS), influences systemic acid-base balance, serves as a medium for the supply of nutrients to neuronal and glial cells, functions as a lymphatic system for the CNS by removing the waste products of cellular metabolism, and transports hormones, neurotransmitters, releasing factors, and other neuropeptides throughout the CNS. Physiologic impedance or cessation of CSF flow may occur commonly in the absence of degenerative changes or pathology and may compromise the normal physiologic functions of the CSF. CSF appears to be particularly prone to stasis within the spinal canal. CSF stasis may be associated with adverse mechanical cord tension, vertebral subluxation syndrome, reduced cranial rhythmic impulse, and restricted respiratory function. Increased sympathetic tone, facilitated spinal segments, dural tension, and decreased CSF flow have been described as closely related aspects of an overall pattern of structural and energetic dysfunction in the axial skeleton and CNS. Therapies directed at affecting CSF flow include osteopathic care (especially cranial manipulation), craniosacral therapy, chiropractic adjustment of the spine and cranium, Network Care (formerly Network Chiropractic), massage therapy (including lymphatic drainage techniques), yoga, therapeutic breath-work, and cerebrospinal fluid technique. Further investigation into the nature and causation of CSF stasis, its potential effects upon human health, and effective therapies for its correction is warranted. PMID:19472865

  20. Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings.

    Science.gov (United States)

    Hämmerle, Gilbert; Strohal, Robert

    2016-04-01

    The aim of this study was to determine the efficacy, safety and cost-effectiveness of an octenidine-based wound gel in the treatment of chronic venous leg ulcers. For this purpose, 49 wounds were treated with either modern wound-phase-adapted dressings alone (treatment arm 1; n = 17), octenidine wound gel plus modern wound-phase-adapted dressings (treatment arm 2; n = 17) or octenidine wound gel alone (treatment arm 3; n = 15). During the study period of 42 days with dressing changes every 3-5 days, wound healing characteristics and treatment costs of different dressings were analysed. Wound size reduction was significantly better (P = 0·028) in both octenidine wound gel treatment arms compared to modern dressings alone with total reductions of 14·6%, 64·1% and 96·2% in treatment arms 1-3. Early wound healing was merely observed under octenidine wound gel treatment (n = 9), whereby lowest treatment costs were generated by octenidine wound gel alone (€20·34/dressing change). As a result, the octenidine wound gel is cost-effective and well suitable for the treatment of chronic venous leg ulcers, considering both safety and promotion of wound healing. PMID:24589044

  1. Travel and venous thrombosis.

    Science.gov (United States)

    Gallus, Alexander S; Goghlan, Douglas C

    2002-09-01

    Debate continues about whether and to what extent travel predisposes to venous thrombosis and pulmonary embolism (PE). Almost certainly, the strength of any association was greatly exaggerated in recent press reports. Conclusions from case-control studies vary, with some finding no excess of recent travel among patients with venous thromboembolism and others reporting a two-four fold excess. The strongest evidence that prolonged air travel predisposes to thrombosis comes from the travel history of people who present with PE immediately after landing. Two independent analyses suggest that the risk of early embolism increases exponentially with travel times beyond 6 hours and may reach 1:200,000 passengers traveling for more than 12 hours. The most likely explanation is venous stasis in the legs from prolonged sitting, and there is evidence (preliminary and controversial) that elastic support stockings may prevent deep vein thrombosis in people who travel long-distances. There is an urgent need for more and better studies to define the absolute hazard from travel-related thrombosis and the personal risk factors that may contribute. Without these, it is difficult to give a balanced account to people who intend to travel or to consider definitive prevention trials. Case reports suggest that in most cases, travel-related thrombosis has affected people who were also at risk because of previous thrombosis, recent injury, or other predispositions. This makes it sensible to target such "at risk" people with advice about hazards and precautions, at least until formal study validates some other approach. PMID:12172438

  2. CEREBROSPINAL FLUID STASIS AND ITS CLINICAL SIGNIFICANCE

    OpenAIRE

    Whedon, James M; Glassey, Donald

    2009-01-01

    We hypothesize that stasis of the cerebrospinal fluid (CSF) occurs commonly and is detrimental to health. Physiologic factors affecting the normal circulation of CSF include cardiovascular, respiratory, and vasomotor influences. The CSF maintains the electrolytic environment of the central nervous system (CNS), influences systemic acid-base balance, serves as a medium for the supply of nutrients to neuronal and glial cells, functions as a lymphatic system for the CNS by removing the waste pro...

  3. Studies on Pathogenesis and Prophylaxis and Treatment of Postvasectomy Epididymal Stasis Syndrome

    Institute of Scientific and Technical Information of China (English)

    刘士怡; 王志新; 吕延鹤; 程继义; 黄真嘉; 高建文; 田奎武

    1996-01-01

    Eighty-four hamsters were vasectomized on both sides, Another group of 76 hamsters was used as the control group. The animal experiment demonstrated that the epididymal function was damaged on the basis of the micropuncture and microanalysis of the epididymal plasma. Histologic examination revealed the dilatation of the lumen, infiltration of chronic inflammatory cells in the interstitium and sperm granuloma. Thirty-nine patients with postvasectomy epididymal stasis were treated with microwave radiation and 10 cases with epididymectomy. The B and C ultrasonography and MRI were used for diagnosis. Histologic examination suggested that chronic obstruction of vasectomy mode (both side electric coagulation or keeping proximal open ) may lead to formation of the new dynamic equilibrium, therefore benefiting the spermatogenesis of testis. Others with acute obstruction of the vas (bilateral ligation) may cause epididymal stasis.

  4. Comparison of arterial and venous blood gases and the effects of analysis delay and air contamination on arterial samples in patients with chronic obstructive pulmonary disease and healthy controls.

    LENUS (Irish Health Repository)

    O'Connor, T M

    2012-01-31

    BACKGROUND: Arterial blood gases (ABGs) are often sampled incorrectly, leading to a \\'mixed\\' or venous sample. Delays in analysis and air contamination are common. OBJECTIVES: We measured the effects of these errors in patients with chronic obstructive pulmonary disease (COPD) exacerbations and controls. METHODS: Arterial and venous samples were analyzed from 30 patients with COPD exacerbation and 30 controls. Venous samples were analysed immediately and arterial samples separated into non-air-contaminated and air-contaminated specimens and analysed at 0, 30, 60, 90 and 180 min. RESULTS: Mean venous pH was 7.371 and arterial pH was 7.407 (p < 0.0001). There was a correlation between venous and arterial pH (r = 0.5347, p < 0.0001). The regression equation to predict arterial pH was: arterial pH = 4.2289 + 0.43113 . venous pH. There were no clinically significant differences in arterial PO associated with analysis delay. A statistically significant decline in pH was detected at 30 min in patients with COPD exacerbation (p = 0.0042) and 90 min in controls (p < 0.0001). A clinically significant decline in pH emerged at 73 min in patients with COPD exacerbation and 87 min in controls. Air contamination was associated with a clinically significant increase in PO in all samples, including those that were immediately analyzed. CONCLUSIONS: Arterial and venous pH differ significantly. Venous pH cannot accurately replace arterial pH. Temporal delays in ABG analysis result in a significant decline in measured pH. ABGs should be analysed within 30 min. Air contamination leads to an immediate increase in measured PO, indicating that air-contaminated ABGs should be discarded.

  5. Effects of Blood-cooling and Stasis-removing Formula on Hemorheology in Rats with Acute Blood Stasis

    Directory of Open Access Journals (Sweden)

    Songyi Ning

    2013-06-01

    Full Text Available Objective: To investigate the effects of blood-cooling and stasis-removing formula on hemorheology in rats with acute blood stasis induced by mutifactor stimuli. Methods: The selected SD rats orally took blood-cooling and stasis-removing granule for six days, then the model of acute blood stasis was prepared on the fifth day by injection of epinephrine combined with ice-water bath. The variations of blood-cooling and stasis-removing granule on hemorheology were detected. Results: The high-dose group of blood-cooling and stasis-removing formula can decrease plasma viscosity in rats with acute blood stasis, and obviously reduce the blood viscosity under the condition of shear rates (200s-1, 30s-1, 5s-1, 1s-1 (P < 0.01, P < 0.05. The middle-dose group can decrease the blood viscosity under the condition of shear rate (30s-1 (P < 0.05. Conclusion: Blood-cooling and stasis-removing formula can improve abnormal hemorheology in rats with acute blood stasis.

  6. Sequelae of Untreated Venous Insufficiency

    OpenAIRE

    Nicholls, Stephen C.

    2005-01-01

    Untreated venous insufficiency results not only in a gradual loss of cosmesis but also in variety of complications including persistent pain and discomfort, hemorrhage, superficial thrombophlebitis, and progressive skin changes that may ultimately lead to ulceration. In rare instances, chronic soft tissue changes may lead to stiffness of the ankle joint, fixed plantar flexion, and periostitis. This article reviews the variety of complications caused by venous insufficiency.

  7. Acute Deep Vein Thrombosis in Venous Aneurysm following Closure of the Chronic Traumatic Arteriovenous Fistulae of the Lower Extremities

    OpenAIRE

    Saranat Orrapin; Supapong Arworn; Kittipan Rerkasem

    2016-01-01

    Chronic traumatic arteriovenous fistula (AVF) commonly results from an unrecognized vascular injury. In this report, there were two cases of chronic traumatic AVF of the legs with a long history of stab (case 1) and shotgun wounds (case 2). Both cases presented with varicose veins together with hyperpigmentation around the ankle of the affected leg. Angiograms showed a single large AVF in case 1, whereas, in case 2, there was a single large AVF together with multiple small AVFs. In both cases...

  8. Associations of anterior accessory or thigh posterior tributary and great saphenous reflux patterns in early stages of chronic venous valvular insufficiency

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Engelhorn

    2014-07-01

    Full Text Available Varicose veins are a common disorder. Extensive ultrasound (US mapping of lower extremity chronic venous valvular insufficiency includes the great saphenous vein (GSV, anterior accessory saphenous vein (AASV and thigh posterior tributary to GSV such as the posterior accessory saphenous vein (PTSV, PASV. The aim of this study was to determine associations between GSV-AASV-PTSV (including PASV reflux in a specific sample population of Southern Brazilian women, mostly euro descendents, with telangiectasias, reticular veins, varices and/or intermittent edema. US performed in 1016 extremities of 513 women, 43±18 (18-81 years old were included. Women with previous venous thrombosis, surgery, suspicion of pelvic congestion syndrome, and men were excluded. Small saphenous vein and related thigh veins were excluded from analysis. GSV-AASV-PTSV reflux patterns were analyzed; prevalence was compared using χ2 statistics. Reflux prevalence in AASV and/or thigh PTSV was 5.8% (59/1016: 1.3% at PTSV (n=13 and 4.5% at AASV (n=46, significantly lower than GSV reflux: 72% (n=727 (P<0.001. AASV and/or PTSV reflux was associated with GSV reflux (81%, n=48/59; common pattern was diffuse reflux, starting at AASV/PTSV saphenous junctions (56%, n=33/59; otherwise, short, non-diffuse reflux was noted in part of the AASV/PTSV evaluated. Isolated AASV or PTSV reflux was rare (1%, n=11/1016: 9 at the AASV, and 2 at the PTSV. US mapping of AASV/PTSV in early stages of disease, in women without pelvic congestion syndrome, increased reflux detection by 1%, and improved definition of reflux patterns in about 6% of the extremities.

  9. Controllori controllati: le finestre della Stasi

    Directory of Open Access Journals (Sweden)

    Alessandra Goggio

    2015-01-01

    Full Text Available This short essay aims to investigate the role played by the object ‘window’ in different post-1989 German representations of the so-called Stasi, that is to say, the secret policy of the German Democratic Republic. In particular, we will linger our attention on a precise situation, that of the controlled-controller, which often recurs in such representations. By analysing three different artistic products (one film: The life of the others by Florian Henckel von Donnersmarck, and two novels: Ich by Wolfgang Hilbig and Helden wie wir by Thomas Brussig we will attempt to show how windows largely contributed not only to the functioning of the Stasi itself, but also to creating a country full of spies spying on one another without even knowing of being controlled by others.In the end we will demonstrate how the use of windows in this particular kind of representation also alludes to the concept of the Panopticon (Jeremy Bentham and its theoretical application carried out by the French philosopher Michael Foucault.

  10. Nutrition and Chronic Wounds: Improving Clinical Outcomes.

    Science.gov (United States)

    Molnar, Joseph A; Vlad, Lucian G; Gumus, Tuna

    2016-09-01

    There is increasing awareness that chronic wound healing is very dependent on the patient's nutritional status, but there are no clearly established and accepted assessment protocols or interventions in clinical practice. Much of the data used as guidelines for chronic wound patients are extrapolated from acutely wounded trauma patients, but the 2 groups are very different patient populations. While most trauma patients are young, healthy, and well-nourished before injury, the chronic wound patient is usually old, with comorbidities and frequently malnourished. We suggest the assumption that all geriatric wound patients are malnourished until proved otherwise. Evaluation should include complete history and physical and a formal nutritional evaluation should be obtained. Laboratory studies can be used in conjunction with this clinical information to confirm the assessment. While extensive studies are available in relation to prevention and treatment of pressure ulcers and perioperative nutrition, less is known of the effect of nutritional deficits and supplementation of the diabetic foot ulcer and venous stasis ulcer patient. This does not necessarily mean that nutritional support of these patients is not helpful. In the pursuit of wound healing, we provide systemic support of cardiac and pulmonary function and cessation of smoking, improve vascular inflow, improve venous outflow, decrease edema, and treat with hyperbaric oxygen. If we address all of these other conditions, why would we not wish to support the most basic of organismal needs in the form of nutrition? PMID:27556777

  11. Electrolytic Inferior Vena Cava Model (EIM) of Venous Thrombosis

    OpenAIRE

    Diaz, Jose A.; Wrobleski, Shirley K.; Hawley, Angela E; Lucchesi, Benedict R.; Wakefield, Thomas W.; Myers

    2011-01-01

    Animal models serve a vital role in deep venous thrombosis (DVT) research in order to study thrombus formation, thrombus resolution and to test potential therapeutic compounds (1). New compounds to be utilized in the treatment and prevention of DVT are currently being developed. The delivery of potential therapeutic antagonist compounds to an affected thrombosed vein has been problematic. In the context of therapeutic applications, a model that uses partial stasis and consistently generates t...

  12. 腓肠肌泵与下肢慢性静脉功能不全%Calf Muscle Pump and Chronic Venous Insufficiency in Lower Extremities

    Institute of Scientific and Technical Information of China (English)

    王昆; 乔正荣; 时德

    2002-01-01

    目的探讨腓肠肌泵功能与下肢慢性静脉功能不全(chronic venous insufficiency,CVI)的关系. 方法复习相关文献,并作综述性报道.结果腓肠肌泵功能的研究方法有空气体积描记法、应变容积描记法、肌肉内压力测定、腓肠肌泵功率测定、足水银应变容积描记法、同位素体积描记法及数字光电容积描记法,测得CVI患者的腓肠肌泵功能明显下降,通过治疗后,腓肠肌泵功能明显改善. 结论腓肠肌泵功能与CVI有密切关系.

  13. Estimating the Clinical Outcomes and Cost Differences Between Standard Care With and Without Cadexomer Iodine in the Management of Chronic Venous Leg Ulcers Using a Markov Model.

    Science.gov (United States)

    Nherera, Leo M; Woodmansey, Emma; Trueman, Paul; Gibbons, Garry W

    2016-06-01

    Chronic venous leg ulcers (VLUs) affect up to 1% of the adult population in the developed world and present a significant financial and resource burden to health care systems. Cadexomer iodine (CI) is an antimicrobial dressing indicated for use in chronic exuding wounds. The aim of this study was to estimate the cost utility of using CI + standard care (SC) - ie, high compression multicomponent bandaging including debridement - compared with SC alone in the management of chronic (>6 months' duration) VLUs from a payer's perspective. A Markov model was constructed to evaluate the cost and clinical benefits (healing and decreased infection rates) of the 2 treatment modalities over a 1-year period using data from 4 randomized, controlled clinical studies (RCTs) included in a recent Cochrane review and cost data from a recently published economic evaluation of VLUs. Costs were calculated using 2014 United States dollars; wound outcomes in- cluded complete healing in 212 patients reported in the Cochrane meta-analysis and quality-adjusted life years (QALYs), with utility values obtained from 200 patients with VLUs calculated using standard gamble. Treatment with CI over 1 year was $7,259 compared to $7,901 for SC. This resulted in a cost savings of $643/patient in favor of CI compared with SC. More patients treated with CI (61%) had their wounds healed compared to 54% treated with SC. Furthermore, patients treated with CI+SC experienced 6 additional ulcer-free weeks compared to persons treated with SC alone (ie, 25 ulcer- free weeks compared to 19 ulcer-free weeks, respectively). Overall, CI resulted in 0.03 more QALYs (ie, 0.86 QALYs compared to 0.83 for SC). The use of CI in addition to SC compared to SC alone over 52 weeks resulted in more wounds healed and more QALYs along with a decrease of overall costs The results of this study suggest CI is cost effective com- pared to SC alone in the management of patients with chronic VLUs. Prospective, controlled clinical

  14. 下肢慢性静脉功能不全动脉铸型的三维重建及意义%Three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity

    Institute of Scientific and Technical Information of China (English)

    黄海龙; 符伟平; 黄绍贤; 龚达聪

    2015-01-01

    目的:探讨下肢慢性静脉功能不全动脉铸型的三维重建及意义。方法采用改良环氧树脂混合液-氧化铅填充剂对1例左侧下肢截肢残体慢性静脉功能不全( CVI)标本进行灌注并铸型,并在铸型基础上行64层螺旋CT薄层扫描,以容积再现法( VR)和最大密度投影法( MIP)重建三维数字化模型。结果血管铸型和CT三维重建的左侧下肢截肢残体CVI动脉模型均清晰地显示下肢动脉的分布及走行、内侧踝关节溃疡灶内踝网血供情况及局部区域性小动脉(微动脉)栓塞情况。结论下肢CVI动脉模型可为CVI确切病因和完善病理机制提供形态学基础,对临床诊断和治疗具有一定指导意义。%Objective To evaluate the three-dimensional reconstruction and significance of arterial cast on chronic venous insufficiency of low extremity. Methods A set of specimen on chronic venous insufficiency of left lower extremity amputation residues was infused with epoxy resin-lead oxide through the femoral artery,and then casted. The CT data of the cast specimen was used to reconstruct 3D modal of ar-tery on chronic venous insufficiency of left lower extremity,using the volume rendering(VR) and maximum intensity projection(MIP). Re-sults The cast specimen and 3D reconstruction of chronic venous insufficiency of left lower extremity amputation residues could clearly dis-play distribution and run of lower extremity arteries,blood supply of lesion and local region embolism of small artery ( arteriole) . Conclusion The 3D modal of artery on chronic venous insufficiency of left lower extremity should provide morphological basis of exact etiology and perfect pathogenesis,also has a certain guiding significance of clinical diagnosis and treatment.

  15. Success rate of split-thickness skin grafting of chronic venous leg ulcers depends on the presence of Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    Høgsberg, Trine; Bjarnsholt, Thomas; Thomsen, Jens Schiersing;

    2011-01-01

    The last years of research have proposed that bacteria might be involved in and contribute to the lack of healing of chronic wounds. Especially it seems that Pseudomonas aeruginosa play a crucial role in the healing. At Copenhagen Wound Healing Centre it was for many years clinical suspected that...... leg ulcers on 91 extremities, from the 1(st) of March 2005 until the 31(st) of August 2006. This was achieved by analysing the microbiology, demographic data, smoking and drinking habits, diabetes, renal impairment, co-morbidities, approximated size and age of the wounds, immunosuppressive treatment...... and complicating factors on the clinical outcome of each patient. The results were evaluated using a Student T-test for continuous parameters, chi-square test for categorical parameters and a logistic regression analysis to predict healing after 12 weeks. The analysis revealed that only 33,3% of...

  16. Venous Aneurysm Complicating Dialytic Arteriovenous Fistula

    OpenAIRE

    Arjun K.Nambiar; Anand, K. T.; Jayakrishnan, A. G.

    2012-01-01

    A case of venous aneurysm complicating arteriovenous fistula created for chronic haemodialysis is presented. The patient underwent successful ligation and excision of the fistula and creation of a fistula on the opposite limb.

  17. Venous Ulcers: New Options in Treatment: Minimally Invasive Vein Surgery

    OpenAIRE

    Poblete, Honesto; Elias, Steven

    2009-01-01

    Venous disease has a spectrum of presentations. The most advanced state of chronic venous insufficiency (CVI) managed by wound care specialists being ulceration of the lower extremity. The goal of all treatments for advanced venous disease is to decrease ambulatory venous hypertension. Treatment can be divided into exogenous and endogenous methods. Exogenous methods include those applied externally such as compression, elevation, debridement and wound dressings. Endogenous methods treat the u...

  18. Probabilidade de refluxo nas veias safenas de mulheres com diferentes graus de insuficiência venosa crônica Reflux probability in saphenous veins of women with different degrees of chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Cassou

    2007-09-01

    Full Text Available CONTEXTO: A presença de refluxo nas junções safeno-femoral e safeno-poplítea é um dado importante para programação da cirurgia de varizes. Estudos mostraram que, na maioria dos pacientes com insuficiência venosa crônica, as junções estão competentes, e o refluxo está presente ao longo do trajeto das veias safenas. OBJETIVOS: Identificar probabilidade de diferentes padrões de refluxo nas veias safenas de mulheres com vários graus de insuficiência venosa crônica e avaliar se o comprometimento das junções das safenas está associado com gravidade da insuficiência venosa. MÉTODOS: Um total de 1.184 membros inferiores de 672 mulheres foram estudados pela ultra-sonografia vascular com Doppler colorido e avaliados pela classificação clínica, etiológica, anatômica e patológica (CEAP. As extremidades foram agrupadas de acordo com a gravidade da insuficiência venosa em graus leve (CEAP C1-C2, moderado (CEAP C3 e grave (CEAP C4-C6. Para avaliar a classificação clínica CEAP na predição do padrão de refluxo, utilizou-se o Teorema de Bayers. Para avaliar associação entre classificação clínica CEAP e padrões de refluxo com ou sem comprometimento das junções das safenas, utilizou-se o teste qui-quadrado (p BACKGROUND: Presence of reflux in saphenofemoral and saphenopopliteal junctions represents important data for indication of varicose vein surgery. Studies demonstrated that in most patients with chronic venous insufficiency junctions are competent and reflux is present in segments in the course of saphenous veins. OBJECTIVES: To identify the probability of different reflux patterns in the saphenous veins of women with various degrees of chronic venous insufficiency and to evaluate whether junction impairment is associated with severity of venous insufficiency. METHODS: A total of 1,184 lower limbs of 672 women were evaluated by color-flow Doppler ultrasonography and classified according to clinical, etiologic

  19. Metástasis coroideas Choroidal metastases

    Directory of Open Access Journals (Sweden)

    C. Camarillo

    2008-01-01

    Full Text Available Las metástasis uveales son el tumor intraocular maligno más frecuente y de ellas, más del 80% se localizan en la coroides. Esto, unido al progresivo aumento de la incidencia, hace necesario su estudio y revisión para un correcto diagnóstico y tratamiento en la práctica clínica actual. La etiología varía según el sexo del paciente, siendo el carcinoma de pulmón el que con más frecuencia metastatiza en el varón y el de mama en la mujer. Tienden a la multifocalidad y generalmente se localizan en el polo posterior. En el 50% de los casos cursan de forma asintomática, pero pueden producir pérdida de visión, escotomas, metamorfopsias, y fotopsias. La exploración oftalmoscópica característica muestra una lesión coroidea placoide, homogénea y de aspecto cremoso. En el diagnóstico diferencial se debe considerar el nevus amelanótico, el melanoma amelanótico de coroides, el hemangioma coroideo, la escleritis posterior, el osteoma de coroides, las coriorretinitis, la enfermedad de Harada, el desprendimiento de retina rhegmatógeno, el síndrome de efusión uveal, y la coriorretinopatía serosa central. Una exhaustiva anamnesis y exploración oftalmológica completa son imprescindibles para el diagnóstico, a lo que se pueden añadir como pruebas complementarias la angiografía con fluoresceína, la ecografía ocular, la punción-aspiración con aguja fina (PAAF, la tomografía computarizada y la resonancia magnética. El tratamiento de estos tumores suele ser el tratamiento sistémico del tumor primario; las posibilidades de tratamiento local son la observación, la radioterapia externa, la braquiterapia, la termoterapia transpupilar y la enucleación.Uveal metastases are the most frequent malign intraocular tumour, of which more than 80% are localized in the choroids. This, together with the progressive increase in its incidence, makes its study and review necessary for a correct diagnosis and treatment in current clinical practice

  20. Reactive Eccrine Syringofibroadenoma Associated with Neuropathy, Venous Stasis, and Diabetic Foot Ulcer

    Science.gov (United States)

    Sirikham, Thirawut; Rojhirunsakool, Salinee; Vachiramon, Vasanop

    2016-01-01

    Eccrine syringofibroadenoma (ESFA) is an uncommon benign adnexal neoplasm which derives from cells of the acrosyringium of eccrine sweat glands. The clinical appearance is nonspecific but the histological features are typical. Five clinical subtypes of ESFA exist: (1) solitary ESFA; (2) multiple ESFA associated with ectodermal dysplasia; (3) multiple ESFA without cutaneous features; (4) unilateral linear ESFA (nevoid), and (5) reactive ESFA associated with inflammatory or neoplastic dermatoses. We report the case of a 42-year-old man with long-standing diabetes and neuropathy, presenting with a 4-year history of asymptomatic erythematous plaques on a background of brown hyperpigmentation on the left foot. The clinical presentation and histopathological findings are compatible with reactive ESFA. PMID:27462220

  1. Inhibitory effect of pentobarbital anesthesia on venous stasis induced arteriolar vasoconstriction in the dog hindleg

    DEFF Research Database (Denmark)

    Bülow, J; Henriksen, O; Amtorp, Ole

    1984-01-01

    vasoconstrictor response was present in both tissues although the response in muscle tissue exhibited a great variation between the dogs during this period. However, after 4-5 h of anesthesia the response was abolished in both tissues. During neurolept anesthesia with fentanyl/N2O the same vasoconstrictor...... vasoconstrictor mechanism of the vascular smooth muscle cells or both. It is suggested that fentanyl/N2O anesthesia is better suited for this kind of studies....

  2. Chronic lymphocytic leukemia presenting with extreme hyperleukocytosis and thrombosis of the common femoral vein.

    Science.gov (United States)

    Cukierman, Tali; Gatt, Moshe E; Libster, Dianna; Goldschmidt, Neta; Matzner, Yaacov

    2002-09-01

    Very few case reports dealing with chronic lymphocytic leukemia (CLL) and hyperleukocytosis have been reported in the medical literature and none with venous thrombosis as a complication. Here, we describe a 73-year-old woman who presented with newly diagnosed CLL, leukostasis, and hyperleukocytosis (2000 x 10(9)/l), affecting the respiratory and nervous system. In addition, she also had deep vein thrombosis (DVT). Although hypercoagulability and thrombosis are well-described phenomena in solid tumors and in myeloproliferative neoplasms, CLL is generally not associated with an acquired coagulopathy. We hypothesize that in our patient the extreme number of circulating lymphocytes resulted in an abnormal accumulation of lymphocytes possibly causing stasis and occlusion of a larger vessel, which resolved after leukopheresis. The patient has since been successfully maintained with chemotherapy. We conclude that leukopheresis should be considered as the therapy of choice in CLL patients presenting with major complications of leukostasis. PMID:12685846

  3. [Current treatment of venous thrombembolism].

    Science.gov (United States)

    Munteanu, Ionuţ

    2013-01-01

    Deep vein thrombosis and pulmonary embolism, considered to be different manifestations of the same disease - venous thromboembolism, have few differences regarding the anticoagulant treatment. However, there are some issues which will be discussed. The therapy objectives in patients with venous thromboembolism include: prevention of death by pulmonary embolism, relieving symptoms in the affected leg, preventing morbidity and prevention of recurrent thromboembolism or postthrombotic syndrome, or minimize symptoms of post-thrombotic syndrome. For most patients, treatment goals are achieved using appropriate anticoagulant therapy, reducing the risk of recurrence in the first three months after diagnosis from over 25% to under 4%. Using of compression socks, providing a gradient of 30-40 mmHg at the ankle for 2 years after the diagnosis, reduce the risk of postthrombotic syndrome. Thrombolysis, applied either systemic or directly by catheter, is indicated in selected cases to prevent onset of postthrombotic syndrome or remove quickly the symptoms due to high venous obstruction. Thrombolytic therapy should be continued with anticoagulant therapy to prevent recurrence of venous thromboembolism. The use of an inferior vena cava filter is indicated for prevention of death by pulmonary embolism in patients who have contraindications to anticoagulant therapy, or anticoagulant treatment that was properly administered remains inefficient. Surgical treatment is recommended in case of chronic pulmonary hypertension, due to thromboembolic disease. PMID:23781572

  4. NeutroPhase® in chronic non-healing wounds

    Science.gov (United States)

    Crew, John; Varilla, Randell; Rocas, Thomas Allandale; Debabov, Dmitri; Wang, Lu; Najafi, Azar; Rani, Suriani Abdul; Najafi, Ramin (Ron); Anderson, Mark

    2012-01-01

    Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient’s morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase® as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase® is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase® with and without NPWT. NeutroPhase® was non-toxic to living tissues. PMID:23272294

  5. NeutroPhase(®) in chronic non-healing wounds.

    Science.gov (United States)

    Crew, John; Varilla, Randell; Rocas, Thomas Allandale; Debabov, Dmitri; Wang, Lu; Najafi, Azar; Rani, Suriani Abdul; Najafi, Ramin Ron; Anderson, Mark

    2012-01-01

    Chronic non-healing wounds, such as venous stasis ulcers, diabetic ulcers, and pressure ulcers are serious unmet medical needs that affect a patient's morbidity and mortality. Common pathogens observed in chronic non-healing wounds are Staphylococcus including MRSA, Pseudomonas, Enterobacter, Stenotrophomonas, and Serratia spp. Topical and systemically administered antibiotics do not adequately decrease the level of bacteria or the associated biofilm in chronic granulating wounds and the use of sub-lethal concentrations of antibiotics can lead to resistant phenotypes. Furthermore, topical antiseptics may not be fully effective and can actually impede wound healing. We show 5 representative examples from our more than 30 clinical case studies using NeutroPhase(®) as an irrigation solution with chronic non-healing wounds with and without the technique of negative pressure wound therapy (NPWT). NeutroPhase(®) is pure 0.01% hypochlorous acid (i.e. >97% relative molar distribution of active chlorine species as HOCl) in a 0.9% saline solution at pH 4-5 and is stored in glass containers. NovaBay has three FDA cleared 510(k)s. Patients showed a profound improvement and marked accelerated rates of wound healing using NeutroPhase(®) with and without NPWT. NeutroPhase(®) was non-toxic to living tissues. PMID:23272294

  6. A diferença na qualidade de vida de pacientes com doença venosa crônica leve e grave Differences in the quality of life of patients with mild and severe chronic venous disease

    Directory of Open Access Journals (Sweden)

    Raymundo Fagner Farias Novais dos Santos

    2009-06-01

    Full Text Available CONTEXTO: A doença venosa crônica atinge os indivíduos em sua fase mais produtiva da vida, acarretando dor, perda de mobilidade e afastamento de atividades, podendo interferir diretamente na qualidade de vida. Seus sintomas clínicos decorrem de um estado de hipertensão venosa, causada por refluxo e/ou obstrução venosa. OBJETIVO: Determinar a diferença na qualidade de vida de pacientes com doença venosa crônica leve e grave. MÉTODOS: Foi realizado estudo transversal analítico comparativo na unidade de saúde durante 8 meses. A amostra foi calculada em 88 pacientes e dividida em dois grupos: Grupo A (CEAP clínico 1, 2 e 3 e Grupo B (CEAP clínico 4, 5 e 6. Foi usado o questionário genérico Medical Outcomes Study - 36-Item Short-Form Health Survey (SF-36. A análise estatística para verificar se havia diferença foi através do teste t de Student, com intervalo de confiança de 95% e p BACKGROUND: Chronic venous disease afflicts individuals in their most productive years, resulting in pain and loss of mobility and independence in performing routine daily activities, which may directly interfere with the patient's quality of life. Clinical symptoms result from venous hypertension caused by reflux and/or venous blockage. OBJECTIVE: To determine differences in the quality of life of patients with mild and severe chronic venous disease. METHODS: A cross-sectional comparative study was conducted in a health care facility during an 8-month period. The sample was composed of 88 patients divided into two groups: group A (clinical CEAP class 1, 2 and 3 and group B (clinical CEAP class 4, 5 and 6. The Medical Outcomes Study - 36-Item Short-Form Health Survey (SF-36 questionnaire was used. Statistical analysis was conducted using the Student t test, with a 95% confidence interval and a level of significance set at p < 0.05. RESULTS: We analyzed 88 subjects, 47 in group A and 41 in group B. Of the total, 87.5% (77 were women and 34% (30 were

  7. Venous Thromboembolic Disease

    OpenAIRE

    Jaff, Michael R

    2002-01-01

    Physicians understand the importance of prompt diagnosis and therapy of venous thromboembolism. This is a common and potentially deadly disease. Many patients may have no symptoms of this disorder, yet face a significant risk of serious complications if undiagnosed and untreated. Venous duplex ultrasonography has become the diagnostic test of choice for deep venous thrombosis. Quantitative d-dimer levels may be very helpful in establishing the diagnosis of venous thrombosis. Helical (spiral) ...

  8. Therapy of chronic wounds with water-filtered infrared-A (wIRA

    Directory of Open Access Journals (Sweden)

    Daeschlein, Georg

    2007-01-01

    Full Text Available The central portion of chronic wounds is often hypoxic and relatively hypothermic, representing a deficient energy supply of the tissue, which impedes wound healing or even makes it impossible. Water-filtered infrared-A (wIRA is a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface. wIRA produces a therapeutically usable field of heat and increases temperature, oxygen partial pressure and perfusion of the tissue. These three factors are decisive for a sufficient tissue supply with energy and oxygen and consequently as well for wound healing, especially in chronic wounds, and infection defense. wIRA acts both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA can advance wound healing or improve an impaired wound healing process and can especially enable wound healing in non-healing chronic wounds. wIRA can considerably alleviate the pain and diminish wound exudation and inflammation and can show positive immunomodulatory effects.In a prospective, randomized, controlled study of 40 patients with chronic venous stasis ulcers of the lower legs irradiation with wIRA and visible light (VIS accelerated the wound healing process (on average 18 vs. 42 days until complete wound closure, residual ulcer area after 42 days 0.4 cm² vs. 2.8 cm² and led to a reduction of the required dose of pain medication in comparison to the control group of patients treated with the same standard care (wound cleansing, wound dressing with antibacterial gauze, and compression garment therapy without the concomitant irradiation. Another prospective study of 10 patients with non-healing chronic venous stasis ulcers of the lower legs included extensive thermographic investigation. Therapy with wIRA(+VIS resulted in a complete or almost complete wound healing in 7 patients and a marked reduction of the ulcer size in another 2 of the 10 patients, a clear reduction of pain and required dose of pain

  9. Clinical unity and community empowerment: the use of smartphone technology to empower community management of chronic venous ulcers through the support of a tertiary unit.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2013-01-01

    Chronic ulcers affect roughly 60,000 Irish people, at a total cost of €600,000,000, or €10,000 per patient annually. By virtue of their chronicity, these ulcers also contribute a significant burden to tertiary outpatient vascular clinics.

  10. Statins improve the resolution of established murine venous thrombosis: reductions in thrombus burden and vein wall scarring.

    Directory of Open Access Journals (Sweden)

    Chase W Kessinger

    Full Text Available Despite anticoagulation therapy, up to one-half of patients with deep vein thrombosis (DVT will develop the post-thrombotic syndrome (PTS. Improving the long-term outcome of DVT patients at risk for PTS will therefore require new approaches. Here we investigate the effects of statins--lipid-lowering agents with anti-thrombotic and anti-inflammatory properties--in decreasing thrombus burden and decreasing vein wall injury, mediators of PTS, in established murine stasis and non-stasis chemical-induced venous thrombosis (N = 282 mice. Treatment of mice with daily atorvastatin or rosuvastatin significantly reduced stasis venous thrombus burden by 25% without affecting lipid levels, blood coagulation parameters, or blood cell counts. Statin-driven reductions in VT burden (thrombus mass for stasis thrombi, intravital microscopy thrombus area for non-stasis thrombi compared similarly to the therapeutic anticoagulant effects of low molecular weight heparin. Blood from statin-treated mice showed significant reductions in platelet aggregation and clot stability. Statins additionally reduced thrombus plasminogen activator inhibitor-1 (PAI-1, tissue factor, neutrophils, myeloperoxidase, neutrophil extracellular traps (NETs, and macrophages, and these effects were most notable in the earlier timepoints after DVT formation. In addition, statins reduced DVT-induced vein wall scarring by 50% durably up to day 21 in stasis VT, as shown by polarized light microscopy of picrosirius red-stained vein wall collagen. The overall results demonstrate that statins improve VT resolution via profibrinolytic, anticoagulant, antiplatelet, and anti-vein wall scarring effects. Statins may therefore offer a new pharmacotherapeutic approach to improve DVT resolution and to reduce the post-thrombotic syndrome, particularly in subjects who are ineligible for anticoagulation therapy.

  11. Venous ulcers of the lower limb: Where do we stand?

    Science.gov (United States)

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein. PMID:23162226

  12. Venous ulcers of the lower limb: Where do we stand?

    Directory of Open Access Journals (Sweden)

    Chatterjee S Sasanka

    2012-01-01

    Full Text Available Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein.

  13. 慢性心力衰竭心气虚兼血瘀水肿证大鼠模型的建立与整合判定%Establishment of Chronic Heart Failure Rat Model of Xin-qi Deficiency Complicated Blood Stasis and Edema Syndrome and Judgment of Diagnosis Information Integration

    Institute of Scientific and Technical Information of China (English)

    林家茂; 郭伟星; 王营; 刘颖; 李亚茹; 李珩; 周杰

    2014-01-01

    血瘀水肿证的SD大鼠模型.%Objective To establish and evaluate chronic heart failure (CHF) rat model of Xin-qi deficiency complicated blood stasis and edema syndrome (XQD-BSES).Methods Totally 40 SD rats were randomly divided into the normal control group (Control),the propylthiouracil (PTU) group,the adriamycin (ADR),and the ADR + PTU group.Normal saline was used as equivalent solvent of each group.Rats in the Control group were intragastrically and intraperitoneally injected with normal saline.Rats in the PTU group were intragastrically injected with PTU suspension and intraperitoneally injected with normal saline.Rats in the ADR group were intragastrically injected with ADR solution and intraperitoneally injected with normal saline.And rats in the ADR + PTU group were intragastrically injected with PTU suspension and intraperitoneally injected with ADR solution.The dose of PTU was 0.2% of daily forage weight,once daily.The dose of ADR was 3.5 mg/kg,once per week.The modeling lasted for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular fraction shortening (LVFS),brain natriuretic peptide (BNP),heart rate (HR),respiratory rate (RR),urine output,ear temperature,exhaustive swimming test (EST),Tri-iodothyronine (T3),tetra-iodothyronine (T4),thyroid stimulating hormone (TSH) as well as heart,lung,liver weight indices and their pathological sections were integrated and compared.Results Compared with the Control group,LVEF,LVFS,BNP,HR,RR,heart,lung,liver weight indices,urine output,ear temperature,EST,and T3,T4,and TSH changed significantly in the ADR group,the PTU group,and the ADR + PTU group with statistical significance (P <0.05),and pathological changes of heart failure occurred in pathological sections of heart,lung,and liver.Compared with the ADR group,LVEF,LVFS,BNP,and lung,liver weight indices,urine output,ear temperature,T3,T4,and TSH changed significantly in the ADR + PTU group with statistical significance (P < 0.05),and

  14. Pathophysiological Characteristics of Phlegm-stasis Cementation Syndrome in Coronary Heart Disease: a Review and Update

    Directory of Open Access Journals (Sweden)

    Jian-Xun Ren

    2016-10-01

    Full Text Available The pathophysiological characteristics of Phlegm-stasis Cementation Syndrome in Coronary Heart Disease (CHD has been summarized in this article. According to epidemiological investigations, phlegm-stasis cementation syndrome has become a dominant syndrome in CHD along with the improvement in living and dietary condition. The interaction between blood stasis and phlegm turbidity that is called Phlegm-stasis Cementation Syndrome exists in CHD and other diseases. The bridge linked blood stasis and phlegm turbidity lies in the adversely effects of lipid metabolism disorder on platelet activation, vascular function and hemorheology indexes. Lipid metabolism disorder also can induce persistent inflammation including monocyte/macrophage activation and oxidative stress. Inflammation also is an important stimulating factor for atherosclerosis and the biology that underlies the complications of CHD, which belonged to the concept of “toxin” in Traditional Chinese medicines (TCM. On the other hand, the important function of inflammatory process on abnormal hemorheology, platelet activation and vascular dysfunction can be used to elucidate the basic pathogenetic condition of the toxin inducing blood stasis in TCM. Therefore, it is this pathological process that can be used to address the basic pathogenetic theory of phlegm turbidity inducing the symptom of toxin and blood stasis, and subsequently phlegm-stasis cementation in TCM. We deduced that lipid metabolic disturbance, inflammation activation, vascular dyfunction and hemorheological disorders could be as pathophysiological characteristics of Phlegm-stasis cementation syndrome.

  15. CD4(+ cells regulate fibrosis and lymphangiogenesis in response to lymphatic fluid stasis.

    Directory of Open Access Journals (Sweden)

    Jamie C Zampell

    Full Text Available INTRODUCTION: Lymphedema is a chronic disorder that occurs commonly after lymph node removal for cancer treatment and is characterized by swelling, fibrosis, inflammation, and adipose deposition. Although previous histological studies have investigated inflammatory changes that occur in lymphedema, the precise cellular make up of the inflammatory infiltrate remains unknown. It is also unclear if this inflammatory response plays a causal role in the pathology of lymphedema. The purpose of this study was therefore to characterize the inflammatory response to lymphatic stasis and determine if these responses are necessary for the pathological changes that occur in lymphedema. METHODS: We used mouse-tail lymphedema and axillary lymph node dissection (ANLD models in order to study tissue inflammatory changes. Single cell suspensions were created and analyzed using multi-color flow cytometry to identify individual cell types. We utilized antibody depletion techniques to analyze the causal role of CD4+, CD8+, and CD25+ cells in the regulation of inflammation, fibrosis, adipose deposition, and lymphangiogenesis. RESULTS: Lymphedema in the mouse-tail resulted in a mixed inflammatory cell response with significant increases in T-helper, T-regulatory, neutrophils, macrophages, and dendritic cell populations. Interestingly, we found that ALND resulted in significant increases in T-helper cells suggesting that these adaptive immune responses precede changes in macrophage and dendritic cell infiltration. In support of this we found that depletion of CD4+, but not CD8 or CD25+ cells, significantly decreased tail lymphedema, inflammation, fibrosis, and adipose deposition. In addition, depletion of CD4+ cells significantly increased lymphangiogenesis both in our tail model and also in an inflammatory lymphangiogenesis model. CONCLUSIONS: Lymphedema and lymphatic stasis result in CD4+ cell inflammation and infiltration of mature T-helper cells. Loss of CD4+ but

  16. Venous Thromboembolism Prophylaxis

    OpenAIRE

    Laryea, Jonathan; Champagne, Bradley

    2013-01-01

    Venous thromboembolism (VTE) can occur after major general surgery. Pulmonary embolism is recognized as the most common identifiable cause of death in hospitalized patients in the United States. The risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) is higher in colorectal surgical procedures compared with general surgical procedures. The incidence of venous thromboembolism in this population is estimated to be 0.2 to 0.3%. Prevention of VTE is considered a patient-safety measur...

  17. Avaliação da circulação arterial pela medida do índice tornozelo/braço em doentes de úlcera venosa crônica Evaluation of arterial circulation using the ankle/brachial blood pressure index in patients with chronic venous ulcers

    Directory of Open Access Journals (Sweden)

    Fabiane Noronha Bergonse

    2006-03-01

    Full Text Available FUNDAMENTOS: As úlceras venosas dos membros inferiores são freqüentes e têm grande impacto na qualidade de vida e produtividade do indivíduo, além de alto custo para a saúde pública. OBJETIVOS: Detecção de alterações arteriais em pacientes de úlcera venosa crônica dos membros inferiores com emprego de método não invasivo, de modo a discriminar aqueles em que estaria contra-indicado o tratamento compressivo. MÉTODOS: Foram estudados 40 doentes portadores de úlcera venosa crônica, com o intuito de se avaliar a presença de doença arterial periférica pela medida do índice tornozelo/braço por doppler-ultra-som. RESULTADOS: O índice tornozelo/braço mostrou-se alterado (menor que 1 em 9/22 (40,9% doentes com úlcera venosa crônica e hipertensão arterial concomitante, e apenas em 1/13 (7,7% doentes de úlcera venosa crônica sem hipertensão arterial. CONCLUSÕES: Doentes de úlcera venosa crônica e hipertensão arterial concomitantes devem ser submetidos rotineiramente à medida do índice tornozelo/braço para detecção de possível insuficiência arterial periférica associada.BACKGROUND: Chronic venous ulcers are extremely frequent and have a significant impact on quality of life and work productivity of individuals, in addition to high costs to public health. OBJECTIVES: Detection of arterial circulation alterations in chronic venous ulcer legs using a non-invasive method to discriminate patients not indicated to have compressive treatment. METHODS: Forty patients with chronic venous ulcers were investigated for the presence of peripheral arterial disease with measurement of the ankle/brachial index by Doppler ultrasound. RESULTS: The resting ankle/brachial pressure index was abnormal (lower than 1 in 9/22 (40.9% patients with concomitant chronic venous ulcers and hypertension and only in one out of 13 (7.7% patients with chronic venous ulcers and no hypertension. CONCLUSIONS: Patients with concomitant chronic venous

  18. Metástasis de los simulacros y metástasis digital en "La novela perfecta" de Carmen Boullosa

    OpenAIRE

    López Pellisa, Teresa

    2013-01-01

    Hemos diagnosticado como metástasis de los simulacros a la patología que se produce en algunos textos cuya temática gira en torno a la realidad virtual. La podemos detectar cuando analizamos la función del incremento de niveles de simulación, a través de lo que hemos denominado metadiégesis digital. Con esta herramienta podemos diseccionar los diversos niveles de virtualidad y realidad virtual generados por máquinas digitales en los textos literarios y cinematográficos de ciencia ficción, par...

  19. Doença veno-linfática: alterações linfocintilográficas nas úlceras venosas Venous-lymphatic disease: lymphoscintigraphic abnormalities in venous ulcers

    Directory of Open Access Journals (Sweden)

    José Humberto Silva

    2009-03-01

    lymphoscintigraphic findings in patients with chronic venous ulcers of the lower limbs. Methods: Forty patients with unilateral chronic venous ulcer or scar were submitted to bilateral lymphoscintigraphy of the lower limbs. The sample was comprised of 25 women and 15 men, with a mean age of 53.7 years (28 to 79 and mean ulcer duration of 71.5 months (3 to 240 months. Lymphoscintigraphic parameters were qualitatively compared among three groups of lower limbs previously classified according to the clinical, etiologic, anatomic and pathologic classification (CEAP: I, limbs without clinical signs of venous disease or with telangiectasias and/or reticular veins (classes 0 and 1; II, limbs with varicose veins, edema and/or skin and subcutaneous alterations (classes 2, 3 and 4; III, lower limbs with ulcer and/or ulcer scars (classes 5 and 6. Results: There was a significant difference (p < 0.001 in the comparison of lymphoscintigraphic findings of the lower limbs with (group III - classes 5 and 6 and without ulcers/scars (groups I and II - classes 0, 1, 2, 3 and 4. There was also a significant difference (p < 0.001 in the comparison of groups according to the clinical CEAP classification: lymphoscintigraphic abnormalities were present in 72.5% in group III (classes 5 and 6, in 30.8% in group II (classes 2, 3 and 4, and in 7.1% in group I (classes 0 and 1. There was a statistically significant difference between group III and the other groups with regard to radiotracer retention, inguinal adenomegaly and dermal reflux. There was no significance as to the parameters popliteal lymph node and collateral circulation. Conclusion: The more severe the venous chronic stasis, the more lymphoscintigraphic abnormalities were observed, corroborating the association between venous and lymphatic disease and between chronic venous stasis and secondary lymphedema.

  20. Duration of wound fluid secretion from chronic venous leg ulcers is critical for interleukin-1α, interleukin-1β, interleukin-8 levels and fibroblast activation

    DEFF Research Database (Denmark)

    Zillmer, Rikke; Trøstrup, Hannah; Karlsmark, Tonny;

    2011-01-01

    Wound fluid collected from chronic wounds may be used as a simple gauge of the processes taking place in the tissue. There is lack of information on the optimal conditions for wound fluid procurement. We have studied possible diurnal variations and duration of wound fluid accumulation using reten...

  1. Water-filtered infrared-A (wIRA in acute and chronic wounds

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    Hoffmann, Gerd

    2009-12-01

    Full Text Available Water-filtered infrared-A (wIRA, as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA increases tissue temperature (+2.7°C at a tissue depth of 2 cm, tissue oxygen partial pressure (+32% at a tissue depth of 2 cm and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense. wIRA can considerably alleviate pain (without any exception during 230 irradiations with substantially less need for analgesics (52–69% less in the groups with wIRA compared to the control groups. It also diminishes exudation and inflammation and can show positive immunomodulatory effects. The overall evaluation of the effect of irradiation as well as the wound healing and the cosmetic result (assessed on visual analogue scales were markedly better in the group with wIRA compared to the control group. wIRA can advance wound healing (median reduction of wound size of 90% in severely burned children already after 9 days in the group with wIRA compared to 13 days in the control group; on average 18 versus 42 days until complete wound closure in chronic venous stasis ulcers or improve an impaired wound healing (reaching wound closure and normalization of the thermographic image in otherwise recalcitrant chronic venous stasis ulcers both in acute and in chronic wounds including infected wounds. After major abdominal surgery there was a trend in favor of the wIRA group to a lower rate of total wound infections (7% versus 15% including late infections following discharge from hospital (0% versus 8% and a trend towards a shorter postoperative hospital stay (9 versus 11 days. Even the normal wound healing process can be improved.The mentioned effects have been proven in six

  2. Venous flow velocity, venous volume and arterial blood flow

    International Nuclear Information System (INIS)

    The relationship of arterial blood flow and venous volume to venous flow velocity was studied in normal subjects. The effects of current modes of treatment in venous thrombosis and of a vasodilator drug on venous flow velocity were also investigated. Total calf flow and venous volume were measured by venous occlusion plethysmography while venous flow axial velocity was determined by the transit time of 131I albumin from calf to inguinal region. Local intravenous epinephrine administration induced venoconstriction and increased venous flow velocity. Intra-arterial isoproterenol and angiotensin increased and decreased arterial flow, respectively, with no change in venous flow velocity or volume, but local heat increased arterial flow and venous flow velocity with no change in venous volume. Local cold, despite venoconstriction, decreased venous flow velocity accompanied by decreased arterial flow. Intravenous heparin did not affect venous flow velocity. Intravenous but not oral nylidrin increased venous flow velocity. Therefore venous flow velocity can be significantly increased by venoconstriction, by large increases in arterial flow (local heat), and by a parenteral vasodilator drug. These experiments indicate that there is a basis for applying heat but not cold in the prevention and treatment of venous thrombosis

  3. Success rate of split-thickness skin grafting of chronic venous leg ulcers depends on the presence of Pseudomonas aeruginosa: a retrospective study

    DEFF Research Database (Denmark)

    Høgsberg, Trine; Bjarnsholt, Thomas; Thomsen, Jens Schiersing;

    2011-01-01

    The last years of research have proposed that bacteria might be involved in and contribute to the lack of healing of chronic wounds. Especially it seems that Pseudomonas aeruginosa play a crucial role in the healing. At Copenhagen Wound Healing Centre it was for many years clinical suspected that...... leg ulcers on 91 extremities, from the 1(st) of March 2005 until the 31(st) of August 2006. This was achieved by analysing the microbiology, demographic data, smoking and drinking habits, diabetes, renal impairment, co-morbidities, approximated size and age of the wounds, immunosuppressive treatment...... and complicating factors on the clinical outcome of each patient. The results were evaluated using a Student T-test for continuous parameters, chi-square test for categorical parameters and a logistic regression analysis to predict healing after 12 weeks. The analysis revealed that only 33,3% of...

  4. Effects of some pharmacological agents on the survival of unipedicled venous flaps: an experimental study.

    Science.gov (United States)

    Askar, I; Saray, A; Gurlek, A; Sevin, K; Sabuncuoglu, B T

    2001-01-01

    Clinical and experimental studies have been conducted to improve the survival of venous flaps. As a result of these studies, although various survival mechanisms were raised, none obtained satisfactory information. Venous stasis, and the resultant venous thrombosis, is a factor that decreases the survival of venous flaps. In this study, we evaluated the effects of two antiinflammatory agents, etodolac and etofenamate, on the survival of unipedicled venous flaps. In this study, 35 male New Zealand white rabbits (3,500-4,000 g) (70 ears) were used. Perichondrocutaneous flaps, 3 x 4.5 cm in size, were designed and raised, keeping the central veins intact in the middle of venous flap. Central arteries and nerves were ligated and transected both proximally and distally, to prepare unipedicled venous flaps. A silicone sheet was placed between the cartilage tissue and flap, to prevent blood flow and revascularization beneath. The subjects were divided into seven groups, consisting of five rabbits (10 ears). In the negative control group (group I), the single vascular pedicle of venous flaps, central veins were ligated and flaps sutured into their own place as the composite graft. In the positive control group (group II), after venous flaps were prepared, normal saline, 0.2 mL, was given subcutaneously. In the first of five experimental groups (group III), unfractionated heparin (100 U/day) was given subcutaneously. In the second experimental group (group IV), etodolac (5 mg/kg/day) was given subcutaneously. In the third experimental group (group V), etophenamate (5 mg/kg/day) was given orally through a feeding tube. In the fourth experimental group (group VI), parnaparin (5 anti-Xa U/kg/day) was given subcutaneously. In the fifth experimental group (group VII), nadroparin (5 anti-Xa U/kg/day) was given subcutaneously, about 7 days postoperatively. At the eighth postoperative day, surviving areas of venous flaps were measured, and the results were evaluated by Kruskal

  5. The treatment of venous ulcers of the lower extremities

    OpenAIRE

    Whiddon, Lonnie L.

    2007-01-01

    Venous hypertension from failure of proper venous valve function in the veins of thelower extremities causes changes over time in the microcirculation of the skin of the distal extremity. These changes set the stage for the development of a chronic nonhealing ulceration, which typically occurs at the ankle. The mainstay of treatment has been conservative, with compression dressings and elevation of the extremity. However, results have been less than satisfactory because of delay in healing an...

  6. Brain venous pathologies: MRI findings

    International Nuclear Information System (INIS)

    Purpose: To describe MRI findings of the different brain venous pathologies. Material and Methods: Between January 2002 and March 2004, 18 patients were studied 10 males and 8 females between 6 and 63 years old; with different brain venous pathologies. In all cases brain MRI were performed including morphological sequences with and without gadolinium injection and angiographic venous sequences. Results: 10 venous occlusions were found, 6 venous angiomas, and 2 presented varices secondary to arteriovenous dural fistula. Conclusion: Brain venous pathologies can appear in many different clinical contexts, with different prognosis and treatment. In all the cases brain MRI was the best imaging study to disclose typical morphologic abnormalities. (author)

  7. RELATIONSHIP BETWEEN SORE VASITIS NODE,EPIDIDYMAL STASIS AND ANTISPERM ANTIBODY AFTER VASECTOMY

    Institute of Scientific and Technical Information of China (English)

    HUANGMing-Kong; MATian-Gen

    1989-01-01

    253 cases without any complcation and 20 cases with sore vasitis node and epididymal stasis were selected at random among those who had reccived vasectomy in an epidcmiological study on the safety of vasectomy. 319 married men having offsprings

  8. VENOUS INSUFFICIENCY AND THROMBOEMBOLIC DISEASE IN BARIATRIC SURGERY PATIENTS

    Directory of Open Access Journals (Sweden)

    Bonno van BELLEN

    2013-09-01

    Full Text Available Context Morbid obesity is associated with various co-morbidities, including chronic venous insufficiency. Bariatric surgery is the only effective treatment for morbid obesity, but with potential risks and possible complications, including venous thromboembolism. Objective To determine the prevalence of clinical and ultrasonographic signs of chronic venous insufficiency in morbid obese patients in preparation for bariatric surgery and the incidence of post-operative venous thromboembolic disease. Methods Patients on work-up for bariatric surgery of Centro Terapêutico Especializado em Fígado (CETEFI and Pro-Gastro surgical teams of the Hospital Beneficência Portuguesa de São Paulo were included. The analysed data were pre-operative findings for venous insufficiency (CEAP - clinical, etiological, anatomical, physiopathologic - classification and venous ultrassonographic findings, type of surgery (open or laparoscopic, abdominal circumference, body mass index (BMI and post-operative ultrassonography search for venous insufficiency and deep venous thrombosis. Results Between March 2007 and December 2009, 95 patients candidates for bariatric surgery had clinical and duplex scan evaluation of the lower limbs venous system. Of the 95 patients, 53 were submitted to the surgical procedure. There was a predominance of women (77.9%, the average age was 38.5 years, average preoperative weight 124.6 kg and average BMI of 45.5 kg/m2. Regarding obesity, 16.8% were obese, and 83.1% were morbidly obese. In relation to the venous findings, 86.3% of the patients did fit CEAP classification less than 3 and 13.7% greater than or equal to 3. Among the post-operative complications, there were four cases of wound infection. Three patients developed post-operative distal venous thrombosis (7.5%, but no one had clinically manifested pulmonary embolism. Conclusion No relation between BMI, CEAP classification and venous ultrassonographic findings were found. Although

  9. Hormonal contraception and venous thromboembolism

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Milsom, Ian; Geirsson, Reynir Tomas;

    2012-01-01

    New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published.......New studies about the influence of hormonal contraception on the risk of venous thromboembolism (VTE) have been published....

  10. Resultados do tratamento da Insuficiência Venosa Crônica grave com espuma de polidocanol guiada por ultrassom Results of treatment of severe chronic venous insufficiency with ultrasound-guided polidocanol foam

    Directory of Open Access Journals (Sweden)

    Melissa Andreia de Moraes Silva

    2012-09-01

    Full Text Available CONTEXTO: A insuficiência venosa crônica (IVC em suas formas mais graves, com ulceração e lesões inflamatórias, associa-se a um tratamento cirúrgico convencional de difícil execução. A escleroterapia de veias tronculares com espuma de polidocanol é considerada uma alternativa terapêutica com resultados satisfatórios. OBJETIVO: Relatar os resultados da escleroterapia com espuma de polidocanol no tratamento de pacientes com IVC de membros inferiores com úlcera ativa. MÉTODOS: Em um período de 48 meses, 71 pacientes (76 membros foram submetidos à escleroterapia de veias tronculares com espuma de polidocanol a 3% guiada por ultrassom. O seguimento pós-procedimento foi feito por meio de questionário clínico, exame físico e ultrassom Doppler, realizados em sete dias, um e seis meses e, a partir de então, semestralmente. Analisou-se tempo de cicatrização da úlcera, melhora de sintomas clínicos, recanalização, recidiva dos sintomas e complicações. RESULTADOS: O sexo feminino correspondeu a 61% dos casos, e a idade variou de 25 a 85 anos (média de 59 anos. O tempo médio de acompanhamento foi de 460 dias. O refluxo do sistema venoso profundo foi observado em 53,4% dos membros. A cicatrização das úlceras ocorreu em 84,2% dos casos, com um tempo médio de cicatrização de 37 dias. A recanalização ocorreu em 31,5%, porém a recidiva de sintomas, com ressurgimento de úlcera, foi de 11,8%. CONCLUSÃO: A esclerose com espuma é efetiva e apresenta altas taxas de cicatrização de úlceras, com baixos índices de complicações, em pacientes com IVC grave.BACKGROUND: Chronic Venous Insufficiency (CVI in its most severe forms, with ulceration and inflammatory lesions, is associated with a conventional surgical treatment of difficult execution. Polidocanol foam sclerotherapy of saphenous veins is considered an alternative therapy with satisfactory results. OBJECTIVE: To report the results of polidocanol foam sclerotherapy in

  11. Venous thromboembolism: The intricacies

    Directory of Open Access Journals (Sweden)

    Dutta T

    2009-01-01

    Full Text Available Venous thromboembolism (VTE has been a subject of great interest of late. Since Rudolph Virchow described the famous Virchow′s triad in 1856, there have been rapid strides in the understanding of the pathogenesis and factors responsible for it. Discovery of various thrombophilic factors, both primary and acquired, in the last 40 years has revolutionized prognostication and management of this potentially life-threatening condition due to its associated complication of pulmonary thromboembolism. Detailed genetic mapping and linkage analyses have been underlining the fact that VTE is a multifactorial disorder and a complex one. There are many gene-gene and gene-environment interactions that alter and magnify the clinical picture in this disorder. Point in case is pregnancy, where the risk of VTE is 100-150 times increased in the presence of Factor V Leiden, prothrombin mutation (Prothrombin 20210A and antithrombin deficiency. Risk of VTE associated with long-haul air flight has now been well recognized. Thrombotic events associated with antiphospholipid syndrome (APS are 70% venous and 30% arterial. Deep venous thrombosis and pulmonary embolism are the most common venous events, though unusual cases of catastrophes due to central vein thrombosis like renal vein thrombosis and Budd-Chiari syndrome (catastrophic APS may occur.

  12. Venous interventions in children.

    Science.gov (United States)

    Kukreja, Kamlesh; Vaidya, Sandeep

    2011-03-01

    Advanced medical treatment options have improved pediatric survival but often require invasive vascular procedures or venous access. These procedures increase the risk for thromboembolism in children, and there has been a corresponding increase in the reported incidence of deep venous thrombosis and postthrombotic syndrome in the pediatric population. Percutaneous venous interventions using catheter-directed therapy (CDT), like mechanical thrombectomy and infusion thrombolysis, have been used much less frequently in children, even though they have shown good results in adults. A multidisciplinary team including pediatric hematology, interventional radiology, and intensive care unit is suggested for management of venous thrombosis in children. Indications and contraindications for CDT in children are similar to adults. Mechanical thrombectomy and infusion thrombolysis are some of the more commonly performed treatments. CDT in children requires adapting to patient size and locally available equipment. Ultrasound guidance for access, "cork" technique, appropriate dosing of tissue plasminogen activator for infusion/pharmacomechanical thrombolysis, and simultaneous administration of heparin, plasminogen (fresh frozen plasma), and deficient coagulation factors are some of the important variations of CDT technique in children. Postprocedure monitoring is very important for successful thrombolysis. Retrievable inferior vena cava filters are increasingly being used in children as well, for prophylaxis against pulmonary embolism (PE) if there is a significant risk of PE with/without contraindications to anticoagulation. PMID:21335289

  13. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel on transcutaneous PO2 in venous insufficiency.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Ippolito, E; Ricci, A; Ruffini, M; Dugall, M

    2004-01-01

    A gel including aescin, essential phospholipids (EPL), and heparin (EG) has been used for many years for local treatment of venous, microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with this compound. The aim of this study was the evaluation of the efficacy of the effects of an AEPL (aescin+EPL) gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Transcutaneous PO(2) was measured at the perimalleolar region. After 2 weeks of treatment, all individual values (100%) were significantly increased (p < 0.05). In all patients, PO(2) increased, indicating a decrease in level of venous microangiopathy. Considering transcutaneous skin PO(2), treatment with AEPL in areas of venous microangiopathy is beneficial in the prevention of ulceration and improves skin healing. PMID:15156250

  14. Advances in our understanding of mechanisms of venous thrombus resolution.

    Science.gov (United States)

    Altmann, Johanna; Sharma, Smriti; Lang, Irene M

    2016-01-01

    Traditionally, venous thrombosis has been seen as the consequence of a regulated cascade of proteolytic steps leading to the polymerization of fibrinogen and fibrin crosslinking that is facilitated by platelets. A new view of thrombosis is providing a more integrated concept, with components of the vascular wall contributing to the vascular remodeling of thrombosis. Angiogenesis and inflammation are two key mechanisms that safeguard venous thrombus resolution and restitution of vascular patency after thrombosis. Disturbance of these processes leads to thrombus persistence and has potentially severe consequences for affected patients. Examples for clinical conditions associated with recurrent or persisting venous thrombosis are post-thrombotic syndrome or chronic thromboembolic pulmonary hypertension. Recently, studies using animal models of venous thrombosis have contributed to a better understanding of thrombus non-resolution that will eventually lead to modification of current treatment concepts. For example, recent data suggest that innate immunity is involved in the modification of thrombosis. PMID:26629617

  15. Venous interventions. Pt. 1. Techniques and lower torso thromboses

    International Nuclear Information System (INIS)

    Venous thrombosis is one of the most common vascular diseases. Without treatment, pulmonary embolism is a potentially life-threatening complication. Long-term complications are chronic venous insufficiency and post-thrombotic syndrome. Medical anticoagulation is currently the standard therapy, since it prevents appositional thrombus growth although it usually can not prevent the development of post-thrombotic syndrome. The structure of the thrombotic material often leads to partial recanalisation with residual stenosis. Early and sufficient systemic thrombolysis with adequate concentration may achieve disintegration of the thrombus and preservation of venous valve function. Supplementary to conservative therapy, local catheter thrombolysis is possible even in cases with contraindications for a systemic thrombolysis therapy. Additional interventional techniques reduce the required concentration of the thrombolytic. Venous stenosis can be treated by balloon angioplasty and stent implantation. This article reviews the different percutaneous treatment options as well as their application and usefulness in thrombosis of the lower torso. (orig.)

  16. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Kevin S.H. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Dowd, Christopher F.; Hess, Christopher P. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Mathes, Erin F.; Frieden, Ilona J. [University of California, San Francisco, Department of Dermatology, San Francisco, CA (United States); Rosbe, Kristina W. [University of California, San Francisco, Department of Otolaryngology, San Francisco, CA (United States); Hoffman, William Y. [University of California, San Francisco, Department of Surgery, San Francisco, CA (United States)

    2015-10-15

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  17. MRI phenotypes of localized intravascular coagulopathy in venous malformations

    International Nuclear Information System (INIS)

    The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications. The aim of this work was to identify MRI features of venous malformation associated with LIC. We hypothesized that venous malformations with larger capacitance, slower flow and less physiological compression (greater stasis) were more likely to be associated with LIC. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed clinical records and MRI for consecutive patients undergoing evaluation of venous malformations at our multidisciplinary Birthmarks and Vascular Anomalies Center between 2003 and 2013. Inclusion required consensus diagnosis of venous malformation and availability of laboratory data and MRI; patients on anticoagulation or those previously undergoing surgical or endovascular treatment were excluded. LIC was diagnosed when D-dimer exceeded 1,000 ng/mL and/or fibrinogen was less than 200 mg/dL. Two board-certified radiologists assessed the following MRI features for each lesion: morphology (spongiform vs. phlebectatic), presence of phleboliths, size, location (truncal vs. extremity), and tissue type(s) involved (subcutis, muscle, bone and viscera). Univariate logistic regression analyses were used to test associations between LIC and MRI findings, and stepwise regression was applied to assess the significance of the individual imaging predictors. Seventy patients, 37 with LIC, met inclusion criteria during the 10-year study period (age: 14.5 +/- 13.6 years [mean +/- standard deviation]; 30 male, 40 female). Both elevated D-dimer and low fibrinogen were associated with the presence of

  18. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence.

    Science.gov (United States)

    Lee, Byung B; Nicolaides, Andrew N; Myers, Kenneth; Meissner, Mark; Kalodiki, Evi; Allegra, Claudio; Antignani, Pier L; Bækgaard, Niels; Beach, Kirk; Belcaro, Giovanni; Black, Stephen; Blomgren, Lena; Bouskela, Eliete; Cappelli, Massimo; Caprini, Joseph; Carpentier, Patrick; Cavezzi, Attilio; Chastanet, Sylvain; Christenson, Jan T; Christopoulos, Demetris; Clarke, Heather; Davies, Alun; Demaeseneer, Marianne; Eklöf, Bo; Ermini, Stefano; Fernández, Fidel; Franceschi, Claude; Gasparis, Antonios; Geroulakos, George; Sergio, Gianesini; Giannoukas, Athanasios; Gloviczki, Peter; Huang, Ying; Ibegbuna, Veronica; Kakkos, Stavros K; Kistner, Robert; Kölbel, Tilo; Kurstjens, Ralph L; Labropoulos, Nicos; Laredo, James; Lattimer, Christopher R; Lugli, Marzia; Lurie, Fedor; Maleti, Oscar; Markovic, Jovan; Mendoza, Erika; Monedero, Javier L; Moneta, Gregory; Moore, Hayley; Morrison, Nick; Mosti, Giovanni; Nelzén, Olle; Obermayer, Alfred; Ogawa, Tomohiro; Parsi, Kurosh; Partsch, Hugo; Passariello, Fausto; Perrin, Michel L; Pittaluga, Paul; Raju, Seshadri; Ricci, Stefano; Rosales, Antonio; Scuderi, Angelo; Slagsvold, Carl E; Thurin, Anders; Urbanek, Tomasz; M VAN Rij, Andre; Vasquez, Michael; Wittens, Cees H; Zamboni, Paolo; Zimmet, Steven; Ezpeleta, Santiago Z

    2016-06-01

    thrombosis indicating their pathophysiological and clinical significance. Chapter 3 describes the hemodynamic changes that occur in different classes of chronic venous disease and their relation to the anatomic extent of disease in the macrocirculation and microcirculation. The next four chapters (Chapters 4-7) describe the hemodynamic changes resulting from treatmen by compression using different materials, intermittent compression devices, pharmacological agents and finally surgical or endovenous ablation. Chapter 8 discusses the unique hemodynamic features associated with alternative treatment techniques used by the CHIVA and ASVAL. Chapter 9 describes the hemodynamic effects following treatment to relieve pelvic reflux and obstruction. Finally, Chapter 10 demonstrates that contrary to general belief there is a moderate to good correlation between certain hemodynamic measurements and clinical severity of chronic venous disease. The authors believe that this document will be a timely asset to both clinicians and researchers alike. It is directed towards surgeons and physicians who are anxious to incorporate the conclusions of research into their daily practice. It is also directed to postgraduate trainees, vascular technologists and bioengineers, particularly to help them understand the hemodynamic background to pathophysiology, investigations and treatment of patients with venous disorders. Hopefully it will be a platform for those who would like to embark on new research in the field of venous disease. PMID:27013029

  19. Primary chronic venous insufficiency of the lower extremities: preoperative color duplex Doppler ultrasound study; Insuficiencia venosa cronica primaria de los miembros inferiores. Valoracion prequirurgica con ecografia Doppler duplex color

    Energy Technology Data Exchange (ETDEWEB)

    Selfa, S.; Diago, T.; Ricart, M.; Chulia, R.; Martin, F. [Hospital Lluis Xativa. Valencia (Spain)

    2000-07-01

    To asses the role of color duplex Doppler ultrasound (CDU) in the preoperative study of patients with varicose veins in lower extremities. We employed CDU to examine varicose veins in 342 lower limbs, assessing reflux in saphenous veins (SV), deep venous system (DVS) and perforating veins (PV). We analyzed the relationship between the anatomical extent of the reflux and the clinical findings. Insufficiency of the superficial venous system alone was uncommon, occurring in only 10.8% of the limbs examined. Reflux was observed in SV and PV in 48.2% of the legs. It was detected in all three systems in 29.2% of cases. The presence of reflux in more than one system and more than one value was associated with increased clinical severity. The site of venous reflux in lower extremities with varicose veins varies. Greater clinical severity is observed in the presence of more marked reflux in the DVS and PV. CDU provides anatomic and functional data on the three venous systems of the lower limbs, allowing an individualized therapeutic surgery. Preoperative localization of incompetent PV by means of CDU facilities their ligation. CDU is the technique of choice for the preoperative examination of the venous systems of patients with varicose veins. (Author)

  20. Nontraumatic vascular emergencies: imaging and intervention in acute venous occlusion

    International Nuclear Information System (INIS)

    Risk factors for acute venous occlusion range from prolonged immobilization to hypercoagulability syndromes, trauma, and malignancy. The aim of this review article is to illustrate the different imaging options for the diagnosis of acute venous occlusion and to assess the value of interventional strategies for venous thrombosis treatment in an emergency setting. First, diagnosis and treatment of the most common form of venous occlusion, at the level of the lower extremities, is presented, followed by pelvic vein and inferior vena cava occlusion, mesenteric venous thrombosis, upper extremity occlusion, acute cerebral vein thrombosis, and finally acute venous occlusion of hemodialysis access. In acute venous occlusion of the lower extremity phlebography is still the reference gold standard. Presently, duplex ultrasound with manual compression is the most sensitive and specific noninvasive test. Limitations of ultrasonography include isolated distal calf vein occlusion, obesity, and patients with lower extremity edema. If sonography is nondiagnostic, venography should be considered. Magnetic resonance venography can differentiate an acute occlusion from chronic thrombus, but because of its high cost and limited availability, it is not yet used for the routine diagnosis of lower extremity venous occlusion only. Regarding interventional treatment, catheter-directed thrombolysis can be applied to dissolve thrombus in charily selected patients with symptomatic occlusion and no contraindications to therapy. Acute occlusion of the pelvic veins and the inferior vena cava, often due to extension from the femoropopliteal system, represents a major risk for pulmonary embolism. Color flow Doppler imaging is often limited owing to obesity and bowel gas. Venography has long been considered the gold standard for identifying proximal venous occlusion. Both CT scanning and MR imaging, however, can even more accurately diagnose acute pelvis vein or inferior vena cava occlusion. MRI is

  1. Chronic Venous Disease (Beyond the Basics)

    Science.gov (United States)

    ... the deep leg veins, from which calf muscles pump blood back to the heart; the valves also control ... play an important role in the circulation of blood, acting as a pump to move blood from the legs back to ...

  2. Increased risk of venous thromboembolism and arterial cardiovascular events in patients with inflammatory bowel disease

    DEFF Research Database (Denmark)

    Kristensen, Søren Lund; Ahlehoff, Ole; Lindhardsen, Jesper;

    2012-01-01

    This focused review describes the current knowledge of the association between inflammatory bowel disease (IBD) and cardiovascular disease. Atherosclerosis is a chronic inflammatory disease, and as well as venous thromboembolism this disease shares inflammatory mechanisms with IBD. Patients...

  3. Estudo da hemodinâmica venosa por meio da pletismografia a ar no pré e pós-operatório de varizes dos membros inferiores Venous hemodynamic study by air plethysmography in the pre- and postoperative period of lower limb varicose veins

    Directory of Open Access Journals (Sweden)

    Nei Rodrigues Alves Dezotti

    2009-03-01

    limbs of 39 patients (35 females and four males, mean age of 46.3 years were evaluated. They were all operated at Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, between January 2001 and December 2004. Lower limbs were classified according to the CEAP classification: clinical criteria = C2 to C6 (C2 = 6, C3 = 32, C4 = 15, C5 = 7 and C6 = 3, etiologic criteria = Ep, anatomic criteria = As, and pathophysiological criteria = Pr. The patients were submitted to pre- and postoperative clinical examination, preoperative duplex scan and pre- and postoperative air plethysmography. Results: Improvement in venous hemodynamics was observed after surgery, confirmed by reduction in the venous filling index and residual volume fraction and increase in the ejection fraction in the lower limbs submitted to varicose vein surgery. Conclusion: Superficial varicose vein stripping contributed to venous stasis relief and provided appropriate treatment, preventing pathophysiological evolution of chronic venous disease independently of clinical severity.

  4. Predicting the Risk of Venous Thromboembolism Recurrence

    OpenAIRE

    Heit, John A.

    2012-01-01

    Venous thromboembolism (VTE) is a chronic disease with a 30% ten-year recurrence rate. The highest incidence of recurrence is in the first 6 months. Active cancer significantly increases the hazard of early recurrence, and the proportions of time on standard heparin (APTT≥0.2 anti-Xa U/mL) and warfarin (INR≥2.0) treatment, significantly reduce the hazard. The acute treatment duration does not affect recurrence risk after treatment is stopped. Independent predictors of late recurrence include ...

  5. Iliofemoral and iliocaval interventions in deep venous thrombosis

    International Nuclear Information System (INIS)

    Significant spontaneous thrombus disintegration in deep venous thrombosis (DVT) occurs very infrequently. On the contrary, these thrombi are prone to appositional growth and migration into the pulmonary arteries. The development of chronic venous insufficiency due to post-thrombotic syndrome is a frequent consequence of DVT. Therapeutic options in DVT include anticoagulation and recanalising procedures such as thrombolysis and thrombectomy. After appropriate indication assessment, the interventional radiologist can offer an efficacy-proven minimally-invasive vessel restitution approach by performing locoregional thrombolysis, pharmacomechanical therapy or, particularly in iliocaval thrombosis, mechanical thrombectomy. These methods not only serve to restitute of vessel patency, but also allow preserving venous valve function. In DVT with recurrent pulmonary embolism, retrievable filters with extended implantation duration can be deployed. In chronic proximal venous flow obstruction or in case of significant residual stenosis after thrombolysis, balloon angioplasty with stent implantation is the treatment modality of choice. Consequently, the radiologist can adopt an important role in the treatment of extensive venous disease. In this article, the treatment modalities concerning iliofemoral and iliocaval thrombosis are demonstrated and illustrated. (orig.)

  6. Transhepatic venous catheters for hemodialysis

    OpenAIRE

    Mohamed El Gharib; Gamal Niazi; Waleed Hetta; Yahya Makkeyah

    2014-01-01

    Purpose: To describe our experience with the technique of transhepatic venous access for hemodialysis and to evaluate its functionality and complications. Patients and methods: From March 2012 till October 2012, 23 patients with age ranging from 12 to 71 years old having end-stage renal disease (ESRD) were included in our study and were subjected to transhepatic venous catheter insertion. In 21 patients there were not any remaining patent peripheral venous accesses. In 2 patients there wer...

  7. Induction of tumour blood flow stasis and necrosis: a new function for epinephrine similar to that of combretastatin A-4 derivative AVE8062 (AC7700).

    Science.gov (United States)

    Hori, K; Saito, S

    2004-01-26

    AVE8062, a derivative of combretastatin A-4, has a strong stanching effect on tumour blood flow (TBF), which leads to complete blockage of nutrient supply to solid tumours and their necrosis. Previously, we reported that TBF stasis is due to increased arteriolar resistance caused by AVE8062 and a lasting decrease in perfusion pressure in tumour-feeding vessels. Here, we measured changes in TBF in rat solid tumour LY80 during continuous administration of AVE8062-like epinephrine or four catecholamines that are unlike AVE8062 (norepinephrine, dopamine, methoxamine, and metaraminol) to the region of increased vascular resistance. Venous administration of 0.3 mg ml(-1) epinephrine caused TBF to fall immediately to near zero, where it remained throughout the administration period. With a 30-min drug administration, TBF began to recover immediately when drug administration halted. With a 60-min epinephrine administration, TBF recovered somewhat, but not to the previous level. With drug administration of 120 min, TBF did not recover during the subsequent 8 h. Likewise, 0.1 mg ml(-1) epinephrine produced irreversible occlusion after 120 min of administration. In contrast, 120 min of administration of the four other catecholamines resulted in no occlusion. Only the group given 0.3 mg ml(-1) epinephrine (not that given methoxamine) showed significantly greater necrosis than the control. We conclude that, for epinephrine to cause irreversible occlusion of these vessels, a marked decrease in perfusion pressure in tumour-feeding blood vessels is necessary and should be maintained for 2 h. This conclusion is consistent with the previously demonstrated mechanism of irreversible arteriole occlusion caused by AVE8062. AVE8062 and epinephrine appear to have the same mechanism of action regarding induction of tumour blood flow stasis. PMID:14735207

  8. Change and stasis in the Iberian Middle Paleolithic. Considerations on the significance of Mousterian technological variability

    OpenAIRE

    Torre, Ignacio de la; Martínez Moreno, Jorge; Mora Torcal, Rafael

    2013-01-01

    The European Mousterian has traditionally been portrayed as a long period of technological stasis as opposed to the technotypological dynamism of Upper Paleolithic cultures. The classic debate on Mousterian variability explained interassemblage differences either by ethnic, cultural, functional, and chronological or by paleoenvironmental causes, but variability was based on typological considerations. Recently, technological factors have been introduced in discussions over time trends and geo...

  9. Assessment of venous leg ulcers: an in-depth discussion of a literature-guided approach.

    Science.gov (United States)

    Kunimoto, B T

    2001-05-01

    Venous leg ulcers represent a significant public health problem that will increase as the population ages. The elderly, the most likely to be afflicted by this condition, present the clinician with special challenges. The diagnosis of venous leg ulcers involves taking a careful history, paying attention to the existence of factors that predispose individuals to the development of chronic venous insufficiency. Clinical features of venous insufficiency are important because their recognition allows clinicians to distinguish venous from other chronic ulcers. An essential part of the assessment of all patients with chronic wounds is an evaluation of intercurrent diseases, common in the elderly, which may impact on the wound healing process. Thus, in addition to managing venous insufficiency and the wound bed, all other factors, systemic and local, that may impede healing need to be investigated and corrected if necessary. Social and psychological issues common to all chronic illnesses need to be addressed as well. This holistic approach should be standard practice and is applicable to the assessment and management of all chronic leg ulcers. This often requires coordinating a multidisciplinary team of wound healing caregivers. More work needs to be done to clarify a few issues because areas of controversy persist. Although a great deal is known about the effects of vitamin deficiency on acute wounds, less is known about chronic ulcers. Similarly, the role of vitamin supplementation in managing chronic ulcers needs further study. Guidelines are needed to determine indications for wound culturing. In addition, more study is required to establish the most effective means of obtaining quantitative cultures. However, the relationship between bacteria and chronic wound healing goes beyond simple quantitation and other factors such as bacterial virulence and host resistance. These controversial issues will be reviewed. Treatment and prevention of venous leg ulcers will be

  10. Cerebral sinus venous thrombosis.

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-10-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  11. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  12. Management of symptomatic venous aneurysm.

    Science.gov (United States)

    Gabrielli, Roberto; Rosati, Maria Sofia; Siani, Andrea; Irace, Luigi

    2012-01-01

    Venous aneurysms (VAs) have been described in quite of all the major veins. They represent uncommon events but often life-threatening because of pulmonary or paradoxical embolism. We describe our twelve patients' series with acute pulmonary emboli due to venous aneurysm thrombosis. Our experience underlines the importance of a multilevel case-by-case approach and the immediate venous lower limbs duplex scan evaluation in pulmonary embolism events. Our data confirm that anticoagulant alone is not effective in preventing pulmonary embolism. We believe that all the VAs of the deep venous system of the extremities should be treated with surgery as well as symptomatic superficial venous aneurysm. A simple excision can significantly improve symptoms and prevent pulmonary embolism. PMID:22566766

  13. Venous thromboembolism in women

    DEFF Research Database (Denmark)

    Group, ESHRE Capri Workshop; Skouby, Sven Olaf

    2013-01-01

    conception occur together. In pregnancy, the risk of VTE is increased ~5-fold, while the use of combined hormonal contraception (CHC) doubles the risk and this relative risk is higher with the more recent pills containing desogestrel, gestodene and drospirenone when compared with those with levonorgestrel....... Similarly, hormone replacement therapy (HRT) increases the VTE risk 2- to 4-fold. There is a synergistic effect between thrombophilia and the various reproductive risks. Prevention of VTE during pregnancy should be offered to women with specific risk factors. In women who are at high risk, CHC and HRT......BACKGROUND Venous thromboembolism (VTE) is a specific reproductive health risk for women. METHODS Searches were performed in Medline and other databases. The selection criteria were high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed...

  14. Venous Thromboembolism. Diagnostic Guide

    International Nuclear Information System (INIS)

    The paper defines to the deep venous thrombosis (DVT) and the development of pulmonary thromboembolism (PTE) as manifestations of oneself pathology. Most of the pistons of the PTE (90%), they originate in the deep veins of the inferior members, proximal to the veins popliteas. In strange occasions, they make it in the veins of the superior members. The diagnosis, localization and extension of the DVT and of the PTE they are necessary to treat appropriately this given illness their high morbid mortality. The great majority of the PTE is symptomatic but it is necessary to know the risk of subsequent PTE examining the permeability of the deep veined system in the patient with suspicion of recent or old PTE to prevent its recurrence

  15. Neumotórax bilateral como complicación de metástasis pulmonar cavitaria de un angiosarcoma

    OpenAIRE

    Lorena V. Maldonado; Silvia Quadrelli; Gustavo Lyons; Juan C. Spina; Julio Venditti; Felipe J. Chertcoff

    2014-01-01

    Las metástasis pulmonares de angiosarcoma constituyen una complicación común de una neoplasia maligna poco frecuente. Habitualmente se presentan como nódulos solidos periféricos y derrame pleural. Presentamos el caso de un hombre de 65 años de edad con neumotórax bilateral recurrente, secundario a metástasis cavitadas de un angiosarcoma primitivo de cuero cabelludo. La videotoracoscopia permitió la inspección, la resección de las metástasis y la pleurodesis. No ocurrieron complicaciones ni re...

  16. Neumotórax bilateral como complicación de metástasis pulmonar cavitaria de un angiosarcoma

    Directory of Open Access Journals (Sweden)

    Lorena V. Maldonado

    2014-06-01

    Full Text Available Las metástasis pulmonares de angiosarcoma constituyen una complicación común de una neoplasia maligna poco frecuente. Habitualmente se presentan como nódulos solidos periféricos y derrame pleural. Presentamos el caso de un hombre de 65 años de edad con neumotórax bilateral recurrente, secundario a metástasis cavitadas de un angiosarcoma primitivo de cuero cabelludo. La videotoracoscopia permitió la inspección, la resección de las metástasis y la pleurodesis. No ocurrieron complicaciones ni recurrencia tumoral a los seis meses de seguimiento.

  17. Epidemiology of recurrent venous thrombosis

    Directory of Open Access Journals (Sweden)

    D.D. Ribeiro

    2012-01-01

    Full Text Available Venous thrombosis, including deep vein thrombosis and pulmonary embolism, is a common disease that frequently recurs. Recurrence can be prevented by anticoagulants, but this comes at the risk of bleeding. Therefore, assessment of the risk of recurrence is important to balance the risks and benefits of anticoagulant treatment. This review briefly outlines what is currently known about the epidemiology of recurrent venous thrombosis, and focuses in more detail on potential new risk factors for venous recurrence. The general implications of these findings in patient management are discussed.

  18. Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion

    International Nuclear Information System (INIS)

    Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.

  19. Measuring venous oxygenation using the photoplethysmograph waveform

    OpenAIRE

    Walton, Z. D.; Kyriacou, P. A.; Silverman, D. G.; Shelley, K. H.

    2010-01-01

    OBJECTIVE: We investigate the hypothesis that the photoplethysmograph (PPG) waveform can be analyzed to infer regional venous oxygen saturation. METHODS: Fundamental to the successful isolation of the venous saturation is the identification of PPG characteristics that are unique to the peripheral venous system. Two such characteristics have been identified. First, the peripheral venous waveform tends to reflect atrial contraction. Second, ventilation tends to move venous blood preferenti...

  20. Cerebral venous thrombosis: diagnosis dilemma

    OpenAIRE

    2011-01-01

    Cerebral venous thrombosis is increasing common disease in daily practice with sharing clinical nonspecific symptoms. This disorder is potentially lethal but treatable, oftenly it was overlooked in both clinical and radiologic in routine practice. Whenever, clinical suspected, prompt investigation by noninvasive imaging Magnetic resonance (MR) or advanced modilities such as cerebral venous thrombosis (CVT), MRV (MR Venography) will helpful in prompt diagnosis and treatment. These imaging moda...

  1. Air travel and venous thromboembolism.

    OpenAIRE

    2002-01-01

    There has recently been increased publicity on the risk of venous thrombosis after long-haul flights. This paper reviews the evidence base related to the association between air travel and venous thromboembolism. The evidence consists only of case reports, clinical case-control studies and observational studies involving the use of intermediate end-points, or expert opinion. Some studies have suggested that there is no clear association, whereas others have indicated a strong relationship. On...

  2. Radioisotopic phlebography in investigating venous diseases of lower limbs

    International Nuclear Information System (INIS)

    The aim of this study is to analyse the interest of isotope phlebography in diagnosis of deep thrombosis and of chronic venous disease in the lower extremity as well as its value in relation to contrast venography. Out of 30 patients, 17 underwent both examinations. With contrast venography as a means of testing, radioisotope phlebography has a sensitivity of 71%, a specificity of 100%, an accuracy of 88%. Thirteen patients only had isotope phlebography. Results were confirmed everybody by clinical developments. The main interest of isotope phlebography is the diagnosis of femoral and iliac thromboses with a sensitivity and specificity of 100% at this point. In chronic venous disease isotope phlebography only shows indirect signs but gives information on the permeability of deep veins, wich is enough to make a therapeutic decision

  3. Exome-wide mutation profile in benzo[a]pyrene-derived post-stasis and immortal human mammary epithelial cells.

    Science.gov (United States)

    Severson, Paul L; Vrba, Lukas; Stampfer, Martha R; Futscher, Bernard W

    2014-12-01

    Genetic mutations are known to drive cancer progression and certain tumors have mutation signatures that reflect exposures to environmental carcinogens. Benzo[a]pyrene (BaP) has a known mutation signature and has proven capable of inducing changes to DNA sequence that drives normal pre-stasis human mammary epithelial cells (HMEC) past a first tumor suppressor barrier (stasis) and toward immortality. We analyzed normal, pre-stasis HMEC, three independent BaP-derived post-stasis HMEC strains (184Aa, 184Be, 184Ce) and two of their immortal derivatives(184A1 and 184BE1) by whole exome sequencing. The independent post-stasis strains exhibited between 93 and 233 BaP-induced mutations in exons. Seventy percent of the mutations were C:G>A:T transversions, consistent with the known mutation spectrum of BaP. Mutations predicted to impact protein function occurred in several known and putative cancer drivers including p16, PLCG1, MED12, TAF1 in 184Aa; PIK3CG, HSP90AB1, WHSC1L1, LCP1 in 184Be and FANCA, LPP in 184Ce. Biological processes that typically harbor cancer driver mutations such as cell cycle, regulation of cell death and proliferation, RNA processing, chromatin modification and DNA repair were found to have mutations predicted to impact function in each of the post-stasis strains. Spontaneously immortalized HMEC lines derived from two of the BaP-derived post-stasis strains shared greater than 95% of their BaP-induced mutations with their precursor cells. These immortal HMEC had 10 or fewer additional point mutations relative to their post-stasis precursors, but acquired chromosomal anomalies during immortalization that arose independent of BaP. The results of this study indicate that acute exposures of HMEC to high dose BaP recapitulate mutation patterns of human tumors and can induce mutations in a number of cancer driver genes. PMID:25435355

  4. Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Mimura, Hidefumi; Fujiwara, Hiroyasu; Hiraki, Takao; Gobara, Hideo; Mukai, Takashi; Hyodo, Tsuyoshi; Iguchi, Toshihiro; Yasui, Kotaro; Kanazawa, Susumu [Okayama University Medical School, Department of Radiology, Okayama (Japan); Kimata, Yoshihiro [Okayama University Medical School, Plastic and Reconstructive Surgery, Okayama (Japan)

    2009-10-15

    The aim of this study was to retrospectively evaluate the safety and efficacy of polidocanol sclerotherapy in pain relief for painful venous malformations (VMs). Thirty-one patients with painful VMs underwent polidocanol sclerotherapy. Pain intensity was assessed with an 11-point verbal numerical rating scale. Sclerotherapy was technically successful in 58 (98.3%) of 59 sessions. Twenty-six (89.7%) out of 29 patients experienced an improvement in pain after sclerotherapy at follow-up, a mean of 46 months after treatment. The mean pain score improved from 6.6 {+-} 2.5 before treatment to 2.4{+-}2.9 after treatment (P<.001). The factors that significantly influenced the therapeutic effect were size of lesion (P=.008), margin of lesion (P=.006), and stasis of sclerosant (P=.032). Adverse events included hypotension and bradycardia during the procedure. No major complication occurred. Polidocanol sclerotherapy is safe and most efficacious in providing pain relief for patients with small VMs (equal to or less than 10 cm in diameter), VMs with a well-defined margin, and VMs with good stasis of sclerosant during sclerotherapy. (orig.)

  5. Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief

    International Nuclear Information System (INIS)

    The aim of this study was to retrospectively evaluate the safety and efficacy of polidocanol sclerotherapy in pain relief for painful venous malformations (VMs). Thirty-one patients with painful VMs underwent polidocanol sclerotherapy. Pain intensity was assessed with an 11-point verbal numerical rating scale. Sclerotherapy was technically successful in 58 (98.3%) of 59 sessions. Twenty-six (89.7%) out of 29 patients experienced an improvement in pain after sclerotherapy at follow-up, a mean of 46 months after treatment. The mean pain score improved from 6.6 ± 2.5 before treatment to 2.4±2.9 after treatment (P<.001). The factors that significantly influenced the therapeutic effect were size of lesion (P=.008), margin of lesion (P=.006), and stasis of sclerosant (P=.032). Adverse events included hypotension and bradycardia during the procedure. No major complication occurred. Polidocanol sclerotherapy is safe and most efficacious in providing pain relief for patients with small VMs (equal to or less than 10 cm in diameter), VMs with a well-defined margin, and VMs with good stasis of sclerosant during sclerotherapy. (orig.)

  6. Effectiveness of papain gel in venous ulcer treatment: randomized clinical trial1

    OpenAIRE

    Ana Luiza Soares Rodrigues; Beatriz Guitton Renaud Baptista de Oliveira; Débora Omena Futuro; Silvia Regina Secoli

    2015-01-01

    OBJECTIVE: to assess the effectiveness of 2% papain gel compared to 2% carboxymethyl cellulose in the treatment of chronic venous ulcer patients. METHOD: randomized controlled clinical trial with 12-week follow-up. The sample consisted of 18 volunteers and 28 venous ulcers. In the trial group, 2% papain gel was used and, in the control group, 2% carboxymethyl cellulose gel. RESULTS: the trial group showed a significant reduction in the lesion area, especially between the fifth and twelfth wee...

  7. Prediction of stasis and crisis in the Bak-Sneppen model

    Science.gov (United States)

    Tejedor, Alejandro; Gómez, Javier B.; Pacheco, Amalio F.

    2009-10-01

    Several recurrences in the dynamics of an individual species in the one-dimensional Bak-Sneppen model are analysed. The distributions of the time intervals for stasis and crisis are separately calculated together with the respective hazard functions for the transition between them. The predictabilities of when a crisis will start and when it will conclude are evaluated by using one- and two-parameter strategies and the information is represented in standard error diagrams.

  8. Prediction of stasis and crisis in the Bak-Sneppen model

    Energy Technology Data Exchange (ETDEWEB)

    Tejedor, Alejandro, E-mail: atejedor@unizar.e [Department of Theoretical Physics, University of Zaragoza, 50009 Zaragoza (Spain); Gomez, Javier B., E-mail: jgomez@unizar.e [Department of Earth Sciences, University of Zaragoza, 50009 Zaragoza (Spain); Pacheco, Amalio F., E-mail: amalio@unizar.e [Department of Theoretical Physics, University of Zaragoza, 50009 Zaragoza (Spain)] [Institute for Biocomputation and Physics of Complex Systems (BIFI), University of Zaragoza, 50009 Zaragoza (Spain)

    2009-10-26

    Several recurrences in the dynamics of an individual species in the one-dimensional Bak-Sneppen model are analysed. The distributions of the time intervals for stasis and crisis are separately calculated together with the respective hazard functions for the transition between them. The predictabilities of when a crisis will start and when it will conclude are evaluated by using one- and two-parameter strategies and the information is represented in standard error diagrams.

  9. Stasis Dermatitis as a Complication of Recurrent Levofloxacin-Associated Bilateral Leg Edema

    OpenAIRE

    Hyman, Daniel A.; Cohen, Philip R.

    2013-01-01

    Introduction: Several drugs have been associated with the development of peripheral edema. Leg edema can result in dermatitis of the lower extremities.  We describe levofloxacin-induced peripheral leg edema, which progressed to stasis dermatitis. Methods: A 76-year-old man with a history of esophageal adenocarcinoma was administered intravenous vancomycin and a combination of piperacillin and tazobactam by injection for treatment of aspiration pneumonia.  Prior to discharge, the pat...

  10. Venous admixture in COPD: Pathophysiology and therapeutic approaches

    OpenAIRE

    Cooper, CB; Celli, B

    2008-01-01

    Chronic obstructive and interstitial lung diseases impair pulmonary gas exchange leading to wasted ventilation (alveolar dead space) and wasted perfusion (venous admixture). These two fundamental types of abnormality represent opposite ends of the spectrum of ventilation-perfusion mismatch with V̇/Q̇ ratios of infinity and zero. Treatment approaches that improve airway function, reduce air trapping and hyperinflation have received much attention and might be successful at ameliorating the pro...

  11. Memory Bandage for Functional Compression Management for Venous Ulcers

    OpenAIRE

    Bipin Kumar; Jinlian Hu; Ning Pan

    2016-01-01

    In current compression practice for the treatment of chronic venous disorders, there has always been a challenge of controlled compression by a bandage to achieve a particular pressure range in the affected region of the limb. The challenges in compression in the products could be solved if there were the possibility of stress control in fabric. Herein, we are exploiting the newly discovered phenomena, i.e., stress memory, in a memory polymer (MP) for the design and investigation of a smart b...

  12. FXIIa inhibitor rHA-Infestin-4: Safe thromboprotection in experimental venous, arterial and foreign surface-induced thrombosis.

    Science.gov (United States)

    May, Frauke; Krupka, Jennifer; Fries, Marion; Thielmann, Ina; Pragst, Ingo; Weimer, Thomas; Panousis, Con; Nieswandt, Bernhard; Stoll, Guido; Dickneite, Gerhard; Schulte, Stefan; Nolte, Marc W

    2016-06-01

    Haemostasis including blood coagulation is initiated upon vessel wall injury and indispensable to limit excessive blood loss. However, unregulated pathological coagulation may lead to vessel occlusion, causing thrombotic disorders, most notably myocardial infarction and stroke. Furthermore, blood exposure to foreign surfaces activates the intrinsic pathway of coagulation. Hence, various clinical scenarios, such as extracorporeal membrane oxygenation, require robust anticoagulation consequently leading to an increased bleeding risk. This study aimed to further assess the antithrombotic efficacy of the activated factor XII (FXIIa) inhibitor, rHA-Infestin-4, in several thrombosis models. In mice, rHA-Infestin-4 decreased occlusion rates in the mechanically-induced arterial (Folt's) and the FeCl3 -induced venous thrombosis model. rHA-Infestin-4 also protected from FeCl3 -induced arterial thrombosis and from stasis-prompted venous thrombosis in rabbits. Furthermore, rHA-Infestin-4 prevented occlusion in the arterio-venous shunt model in mice and rabbits where thrombosis was induced via a foreign surface. In contrast to heparin, the haemostatic capacity in rabbits was unaffected by rHA-Infestin-4. Using rodent and non-rodent species, our data demonstrate that the FXIIa inhibitor rHA-Infestin-4 decreased arterial, venous and foreign surface-induced thrombosis without affecting physiological haemostasis. Hence, we provide further evidence that targeting FXIIa represents a potent yet safe antithrombotic treatment approach, especially in foreign surface-triggered thrombosis. PMID:27018425

  13. [The treatment of malignant tumors on venous leg ulcers. Case presentation and literature review].

    Science.gov (United States)

    Lehnert, W; Kohl, K; Riebe, H; Jünger, M; Ladwig, A

    2008-11-01

    Malignant changes in persistent venous leg ulcers are a grave complication of chronic impaired wound healing. In our case, a venous leg ulcer had persisted on the right calf for 30 years. Exophytic tumors in the ulcer with frequent bleeding prompted biopsies. A squamous cell carcinoma was found, but only in the second biopsy. The surgical procedure was planned so that in a single session both the tumor and the underlying causes of the chronic venous insufficiency in the leg could be treated appropriately. Extirpation of the enlarged lymph nodes in the groin was combined with crossectomy and removal of the long saphenous vein, followed by circular radial excision of the ulcer scar fascia (fasciotomy). The excised tissue was examined histologically. Muscle biopsies were taken from the site of suspicious adhesions of the fascia to the calf muscle. The large, circular defects on the lower leg were covered with the appropriate dressing to condition the wound bed. After three weeks the well-granulated area was covered with meshed split skin grafts. During the operation and in the post-operative phase, machine-assisted and manual decongestion was performed, an established therapy for lymphedema, chronic venous insufficiency and chronic venous ulcers. PMID:18850078

  14. Cerebral venous thrombosis in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Huisman, T.A.G.M.; Martin, E.; Willi, U.V. [Dept. of Diagnostic Imaging and Radiology, University Children' s Hospital Zurich (Switzerland); Holzmann, D. [Dept. of Otorhinolaryngology, University Children' s Hospital Zurich, Zurich (Switzerland)

    2001-09-01

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  15. Cerebral venous thrombosis in childhood

    International Nuclear Information System (INIS)

    This was a retrospective study to determine different etiologies of cerebral venous thrombosis (CVT) in childhood and to correlate extent and location of thrombosis with the etiology and the age of the child as well as the final outcome. In addition, the radiologic approach is discussed. This was a retrospective analysis of 19 children with CVT. The children were examined by contrast-enhanced dynamic CT. Radiologic findings were correlated with the etiology of CVT. Cerebral venous thrombosis is not as infrequent in children as has been thought. Cerebral venous thrombosis in children can occur due to trauma (n=9), infections (n=7), or coagulation disorders (n=3). Extent and location of thrombosis, as well as complications, final outcome, and therapy, depend on the etiology. Computed tomography remains a valuable primary imaging modality in the diagnosis of CVT in the acutely injured or diseased child. (orig.)

  16. Hormonal contraceptives and venous thrombosis

    OpenAIRE

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thrombotic event and to provide an overview of the risk of venous thrombosis per combined oral contraceptive. We found that the UGT2B7 gene in the first-pass metabolism may at least in part explain the r...

  17. Venous Complications of Pancreatitis: A Review

    OpenAIRE

    Yashant Aswani; Priya Hira

    2015-01-01

    Pancreatitis is notorious to cause vascular complications. While arterial complications include pseudoaneurysm formation with a propensity to bleed, venous complications can be quite myriad. Venous involvement in pancreatitis often presents with thrombosis. From time to time case reports and series of unusual venous complications associated with pancreatitis have, however, been described. In this article, we review multitudinous venous complications in the setting of pancreatitis and propose ...

  18. PET/TC de cuerpo completo para la detección de metástasis de melanoma coroideo

    Directory of Open Access Journals (Sweden)

    N.A. Rodríguez-Marco

    2014-08-01

    Full Text Available El melanoma coroideo es el tumor maligno ocular primario más frecuente en los adultos y las metástasis más frecuentes son a nivel hepático con un mal pronóstico a pesar de los tratamientos. Estas metástasis se han descrito hasta en el 50 % de los melanomas coroideos. Estudios recientes muestran que la ecografía hepática y las analíticas hepáticas tienen baja sensibilidad en el diagnóstico de las metástasis hepáticas de los melanomas de úvea. Exponemos el caso de un paciente con historia de melanoma coroideo. La exploración preoperatoria, incluyendo TC de abdomen, analítica sanguínea y enzimas hepáticos resultó normal. En un PET/TC realizado mostró lesiones en el hígado y pulmones. El PET/TC de cuerpo entero mostró metástasis de un melanoma uveal. El PET/TC es una herramienta útil para la detección de las metástasis hepáticas y extrahepáticas.

  19. Obstructive hydrocephalus resulting from cerebral venous thrombosis

    OpenAIRE

    2011-01-01

    Cerebral venous thrombosis is a rare form of stroke in childhood. Increased intracranial pressure is a well-defined complication of cerebral venous thrombosis but obstructive hydrocephalus as a presentation finding of cerebral venous thrombosis is rarely described. A child case of cerebral sinus thrombosis presenting with obstructive hydrocephalus and management of clinical condition is presented with discussion of reported cases and treatment recommendations.

  20. Percutaneous Intervention of Sequential Coronary Venous Graft

    OpenAIRE

    Zeki DOGAN; Karabulut, Ahmet; Uzunlar, Bulent

    2014-01-01

    We present a case with coronary bypass grafts in which venous graft was anastomosed to obtuse marginal (OM) 1 and OM2 branches sequentially. We performed percutaneous intervention to the proximal circumflex (CX), OM1, and bridging segment of the venous graft. Finally, bridging segment of the venous graft began to function as a CX body extending between the OM1 and OM2.

  1. The effect of a silver-containing Hydrofiber dressing on superficial wound bed and bacterial balance of chronic wounds.

    Science.gov (United States)

    Coutts, Pat; Sibbald, R Gary

    2005-12-01

    The treatment of chronic wounds represents a major cost to society and has a profound effect on the participant's quality of life. Chronic wounds may have an increased bacterial burden that can impair healing without all the clinical signs of infection. Silver dressings may provide an alternative topical method to control bacterial burden. The primary aim of this study was to evaluate the clinical improvement in chronic wounds through the effect on wound size, maceration, resolution of surface slough and conversion to healthy granulation during a 4-week application of the silver-containing Hydrofiber dressing. This was a single centre, open-label case series study which included a total of 30 evaluable participants: four with diabetic neuropathic foot ulcers, 13 venous stasis ulcers, four pressure ulcers and nine miscellaneous wounds that did not fit any of the previous categories. All participants had adequate vascular supply, indicating the potential to heal. The wounds were stalled or had the signs and symptoms consistent with critical colonisation. The underlying cause of the ulceration was identified and corrected, or the symptoms and signs were treated. This was followed by the application of silver-containing Hydrofiber dressings for a period of 4 weeks. The majority of wounds treated decreased in size (70%) with decreased exudate, decreased purulence and resolution of surface slough (75%). There was an increased quality and quantity of healthy granulation tissue. Unlike some silver dressings, the Hydrofiber and silver combination dressing was unlikely to cause burning and stinging on application. Peri-wound maceration was present in 54% of participants at baseline, and 85% of these resolved with this dressing. A desloughing action was seen in those patients with pre-existing slough at baseline and its removal will lower the bacterial burden of the wound. PMID:16618321

  2. Urine Stasis Predisposes to Urinary Tract Infection by an Opportunistic Uropathogen in the Megabladder (Mgb Mouse.

    Directory of Open Access Journals (Sweden)

    Brian Becknell

    Full Text Available Urinary stasis is a risk factor for recurrent urinary tract infection (UTI. Homozygous mutant Megabladder (Mgb-/- mice exhibit incomplete bladder emptying as a consequence of congenital detrusor aplasia. We hypothesize that this predisposes Mgb-/- mice to spontaneous and experimental UTI.Mgb-/-, Mgb+/-, and wild-type female mice underwent serial ultrasound and urine cultures at 4, 6, and 8 weeks to detect spontaneous UTI. Urine bacterial isolates were analyzed by Gram stain and speciated. Bladder stones were analyzed by x-ray diffractometry. Bladders and kidneys were subject to histologic analysis. The pathogenicity of coagulase-negative Staphylococcus (CONS isolated from Mgb-/- urine was tested by transurethral administration to culture-negative Mgb-/- or wild-type animals. The contribution of urinary stasis to CONS susceptibility was evaluated by cutaneous vesicostomy in Mgb-/- mice.Mgb-/- mice develop spontaneous bacteriuria (42% and struvite bladder stones (31% by 8 weeks, findings absent in Mgb+/- and wild-type controls. CONS was cultured as a solitary isolate from Mgb-/- bladder stones. Bladders and kidneys from mice with struvite stones exhibit mucosal injury, inflammation, and fibrosis. These pathologic features of cystitis and pyelonephritis are replicated by transurethral inoculation of CONS in culture-negative Mgb-/- females, whereas wild-type animals are less susceptible to CONS colonization and organ injury. Cutaneous vesicostomy prior to CONS inoculation significantly reduces the quantity of CONS recovered from Mgb-/- urine, bladders, and kidneys.CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice.

  3. Laïcité and multiculturalism: the Stasi Report in context.

    Science.gov (United States)

    Akan, Murat

    2009-06-01

    French republican universalism--expressed most strongly in the principle and practice of laïcité--and multiculturalism have constituted opposite poles on questions of citizenship and integration. The report of the Stasi Commission on laïcité on 11 December 2003 and the following legislation on the donning of religious symbols in French public schools have once again, spurred debates over the meanings and practices of laïcité. The report and the law have been interpreted in different ways. Some have presented them as a reaffirmation of a historically constituted laïcité under new circumstances, others as a divergence from the real problems of racism, unemployment and gender inequality. In this article, I offer an alternative reading by supplementing a critical reading of the report with an analysis of its historical and immediate institutional context. I evaluate the Stasi Report in its immediate context of institutional change, and in the historical context of selected developments concerning laïcité since the 1905 law separating churches and State. I argue that the Stasi Report marks a fundamental break with French republican universalism, and I show that this break occurred contemporaneously with key gestures of multiculturalism: the establishment of the French Muslim Council and the creation of Muslim high schools under contract with the French state. This double movement to narrow the boundaries of laïcité, and for the state to expand the boundaries of identity-specific, Muslim public institutions and private schooling constitutes a reorganization of the public sphere in France which qualifies as a move towards multiculturalism. PMID:19489818

  4. Las metástasis óseas del cáncer Bone metastases

    OpenAIRE

    S. Vicent; D. Luis-Ravelo; Antón, I.; Hernández, I.; Martínez, S.; De Las Rivas, J.; A. Gúrpide; Lecanda, F

    2006-01-01

    Las metástasis óseas representan un problema clínico devastador en las neoplasias más frecuentes, especialmente en el mieloma múltiple, mama, próstata, y pulmón. Las consecuencias incluyen dolores refractarios a analgésicos convencionales, osteolisis que conlleva en ocasiones compresión medular, fracturas patológicas, y trastornos metabólicos. Recientes avances en el diagnóstico mediante técnicas de imagen, así como diversas técnicas bioquímicas, han favorecido un certero diagnóstico y seguim...

  5. Hormonal contraceptives and venous thrombosis

    NARCIS (Netherlands)

    Stegeman, Berendina Hendrika (Bernardine)

    2013-01-01

    Oral contraceptive use is associated with venous thrombosis. However, the mechanism behind this remains unclear. The aim of this thesis was to evaluate genetic variation in the first-pass metabolism of contraceptives, to identify the clinical implications of hormonal contraceptive use after a thromb

  6. Efficacy of endovenous ablation of the saphenous veins for prevention and healing of venous ulcers.

    Science.gov (United States)

    Marston, William A

    2015-01-01

    In many countries, endovenous ablation (EVA) has replaced surgical stripping as the preferred method of eliminating saphenous reflux in symptomatic patients. Studies have examined the success of EVA at saphenous closure and improving leg pain and edema. However, less information is available on the ability of these techniques to promote venous leg ulcer healing or to prevent recurrence. The comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR) trial identified the role of saphenous stripping in reducing the rate of ulcer recurrence after healing, supporting this procedure for Clinical, Etiologic, Anatomic, and Pathologic (CEAP) clinical class 5 and 6 patients. In patients with venous ulcers, it remains controversial whether EVA procedures provide results similar to those of saphenous stripping in clinically relevant outcomes. This review examines the evidence supporting the use of thermal or nonthermal EVA in patients with healed or active venous ulcers and saphenous insufficiency. PMID:26993692

  7. Endovascular Treatment Options in the Management of Lower Limb Deep Venous Thrombosis

    International Nuclear Information System (INIS)

    Lower limb deep vein thrombosis (DVT) is a common cause of significant morbidity and mortality. Systemic anticoagulation therapy is the mainstay of conventional treatment instituted by most physicians for the management of DVT. This has proven efficacy in the prevention of thrombus extension and reduction in the incidence of pulmonary embolism and rethrombosis. Unfortunately, especially in patients with severe and extensive iliofemoral DVT, standard treatment may not be entirely adequate. This is because a considerable proportion of these patients eventually develops postthrombotic syndrome. This is characterized by chronic extremity pain and trophic skin changes, edema, ulceration, and venous claudication. Recent interest in endovascular technologies has led to the development of an assortment of minimally invasive, catheter-based strategies to deal with venous thrombus. These comprise catheter-directed thrombolysis, percutaneous mechanical thrombectomy devices, adjuvant venous angioplasty and stenting, and inferior vena cava filters. This article reviews these technologies and discusses their current role as percutaneous treatment strategies for venous thrombotic conditions.

  8. PET/TC de cuerpo completo para la detección de metástasis de melanoma coroideo

    OpenAIRE

    N.A. Rodríguez-Marco; C. Caicedo-Zamudio; S. Solanas-Álava; Gil-Arnaiz, I; A. Córdoba-Iturriagagoitia; J. Andonegui-Navarro

    2014-01-01

    El melanoma coroideo es el tumor maligno ocular primario más frecuente en los adultos y las metástasis más frecuentes son a nivel hepático con un mal pronóstico a pesar de los tratamientos. Estas metástasis se han descrito hasta en el 50 % de los melanomas coroideos. Estudios recientes muestran que la ecografía hepática y las analíticas hepáticas tienen baja sensibilidad en el diagnóstico de las metástasis hepáticas de los melanomas de úvea. Exponemos el caso de un paciente con historia de me...

  9. 从瘀论治消渴病%Discussion of Xiaoke from Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    谢明云

    2012-01-01

    消渴病是以多饮、多食、多尿、形体消瘦或尿有甜味为特征的一种疾病.据临床观察多数2型糖尿病患者常兼见口唇色暗,面有瘀斑或肌肤甲错,舌质紫黯或黯淡,脉细涩,舌下静脉青紫等体征.因此从血瘀探讨糖尿病的病机,从血瘀立论,以活血化瘀为中心,辨证论治糖尿病,逐渐为医学界重视.%Xiaoke is a kind of disease which has major clinical symptoms by drinking and eating more, more urine, becoming angular, or urine with sweet taste. According to clinical observation, most patients with type 2 diabetes mellitus often have signs such as purple or dark lips, dark spot on face, scaly dry skin, dark purple or dull colorful tongue, thin or unsmooth pulse, bluish or purple vein under the tongue. So exploring the pathogenesis of diabetes, making a point based on blood stasis, promoting blood circulation to remove blood stasis and the treatment based on syndrome differentiation of diabetes gradually attract more attention in medical field.

  10. Case of cerebral venous thrombosis with unusual venous infarcts.

    Science.gov (United States)

    Narra, Ramakrishna; Kamaraju, Susheel Kumar; Pasupaleti, Bhimeswarao; Juluri, Naganarasimharaju

    2015-04-01

    Cerebral venous thrombosis is a relatively rare condition when compared with vascular accidents of arterial origin representing 0.5-1% of all strokes. Unlike arterial infarcts parenchymal changes are seldom present and when present most of the times are reversible. We present a case report of 28-year-old female with thrombosis of internal cerebral veins and straight sinus and hemorrhagic infarcts in bilateral basal ganglia and bilateral thalami .The findings of bilateral symmetrical hyper intensities in basal ganglia and thalami on MRI may be due to various causes of diverse etiology and cerebral venous thrombosis remains an important cause. Early recognition and prompt anticoagulation therapy helps to reduce the mortality to a great extent. The MRI imaging features of straight sinus thrombosis and other imaging differentials are discussed. PMID:26023623

  11. Treating Vertigo from Phlegm and Blood Stasis%从痰瘀互结论治眩晕

    Institute of Scientific and Technical Information of China (English)

    周长影; 于睿

    2013-01-01

    The etiology and pathogenesis of vertigo,foundation treatment,TCM theory and modern research is described from the phlegm and blood stasis theory,providing a theoretical basis for treating vertigo from phlegm and blood stasis.%从痰瘀互结的理论阐述眩晕的病因病机、中医理论基础、治疗及现代研究,为眩晕从痰瘀同治的治法方面提供理论依据.

  12. Radiologically-placed venous ports in children under venous anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joo Yeon; Jeon, Ung Bae; Choo, Ki Seok; Hwang, Jae Yeon; Kim, Yong Woo; Lee, Yun Jin; Nam, Sang Ool; Lim, Young Tak [Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2015-02-15

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  13. Radiologically-placed venous ports in children under venous anesthesia

    International Nuclear Information System (INIS)

    To evaluate the efficacy and safety of radiologic venous port placement in children under venous anesthesia. Between April 2009 and July 2011, 44 ports were implanted in 41 children (24 boys, 17 girls). The age of patients ranged from 9 months to 19 years (mean, 6.5 years) and their body weights ranged from 6.8 kg to 56.3 kg (mean, 23.2 kg). Right internal jugular vein access was used in 42 ports, right subclavian vein in 1, and left subclavian in 1. Durability and complications of port implantation were reviewed. The technical success rate was 100%. The catheter life was 10-661 days (mean 246 days). Two patients died during the follow-up period, 21 and 6 ports were removed at the end of treatment or as a result of complications, respectively. One port was removed and replaced by a Hickmann catheter. Three ports were explanted due to port-related sepsis, one due to a catheter kink, and two for unexplained fever or insertion site pain. The overall port-related infection was 3 cases (6.8%, 0.28/1000 catheter days). Venous port placement by interventional radiologists in children under intravenous sedation is relatively safe, with a high rate of technical success and low rate of complications.

  14. Venous sinus stenting for pseudotumour cerebri with venous sinus stenosis

    International Nuclear Information System (INIS)

    Objective: To explore the relation between venous sinus stenosis and pseduotumour cerebri and to discuss the efficacy and strategy of venous sinus stenting for its treatment. Methods: Venous sinus stenting was performed in a total of 9 patients with pseudotumour cerebri accompanied by dural sinus stenosis. The clinical data, including the clinical presentations, intracranial pressure, angiographic findings, pressure of dural sinus,methods of treatment and the therapeutic results, were retrospectively analyzed. Results: Bilateral disc edema was seen in all patients. The pressure gradient in the lateral sinuses was obviously high before stenting (22.67±7.25)mmHg in all patients and a reduction in intra-sinus pressure and pressure gradient was also found (5.78±3.77)mmHg. The symptoms associated with intracranial hypertension were gradually improved or disappeared in two weeks after the placement of the stent in all cases, and the intracranial pressure dropped evidently (12.78±5.97)cm H2O. Vision was improved in 7 cases at three months, whereas it remained poor in 2 cases despite normalized intracranial pressure. There was no other permanent procedure-related morbidity. The patients were followed up for 3 months to 5 years, and no recurrence developed. Conclusion: Lateral sinus stenting is an effective method for the treatment of pseudotumour cerebri with dural sinus stenosis. (authors)

  15. Sepsis, venous return, and teleology.

    Science.gov (United States)

    McNeilly, R G

    2014-11-01

    An understanding of heart-circulation interaction is crucial to our ability to guide our patients through an episode of septic shock. Our knowledge has advanced greatly in the last one hundred years. There are, however, certain empirical phenomena that may lead us to question the wisdom of our prevailing treatment algorithm. Three extreme but iatrogenically possible haemodynamic states exist. Firstly, inappropriately low venous return; secondly, overzealous arteriolar constriction; and finally, misguided inotropy and chronotropy. Following an unsuccessful fluid challenge, it would be logical to first set the venous tone, then set the cardiac rate and contractility, and finally set the peripheral vascular resistance. It is hypothesized that a combination of dihydroergotamine, milrinone and esmolol should be superior to a combination of noradrenaline and dobutamine for surviving sepsis. PMID:25245463

  16. Venous thromboembolism deserves your attention

    OpenAIRE

    Marc Samama, Charles

    2001-01-01

    The survey of how Canadian intensive care units (ICUs) prevent and diagnose venous thromboembolism (VTE) presented in this issue of Critical Care illustrates considerable variability. Lack of optimal patient care reflects how VTE is rated in ICUs. The discussion should no longer focus on the incidence of thrombosis, but rather on its prevention. Unfractionated heparin remains the most commonly used agent to prevent VTE, despite the recognized efficacy and safety of low-molecular-weight hepari...

  17. Cerebral sino-venous thrombosis

    International Nuclear Information System (INIS)

    Three cases of cerebral sino-venous thrombosis were reported. Repeated CT findings were studied and discussed on account of the treatments for those pathologic conditions. Those of studied cases are; a 22-year-old postpartum woman, a 42-year-old woman with irregular vaginal bleeding, and a 26-year-old man with severe reactive emesis after drinking alcohol. They were treated conservatively. Case 1 died in its acute stage. In the remaining ones, each had an uneventful recovery. CT scan findings of them manifested their exact clinical conditions. These findings were devided into two categories, one was direct signs expressed sino-venous occlusion, the other was indirect signs which appeared as a result of these occlusion. Direct signs cannot always get in every cases with sino-venous occlusion, but as for indirect signs, we can get various changes corresponding to the time taken CT photoes, and they are useful to decide appropriate treatments at that time. Considering suitable treatments for this disease, it is necessary to select most suitable ones according to their pathologic conditions, which may be precisely drawn with CT scans. (J.P.N.)

  18. Preparation and analysis of active rat model of rheumatoid arthritis with features of TCM toxic heat-stasis painful obstruction

    Directory of Open Access Journals (Sweden)

    Yanan Wang

    2015-07-01

    Conclusion: The CIA model established in this study presents both active RA pathologic features and characteristics of the symptoms of toxic heat-stasis painful obstruction 12 weeks after successful establishment of an animal model. In addition, this study may be a valuable reference for development of animal studies with combined Eastern and Western medicines in dialectics and identification of diseases.

  19. 重用马鞭草善治慢性肾炎和慢性前列腺炎%Treating chronic nephritis and chronic prostatitis with verbena

    Institute of Scientific and Technical Information of China (English)

    张允学; 吴东伟

    2012-01-01

      马鞭草有清热解毒,活血散瘀,利水消肿的功效,临床上用马鞭草治疗慢性肾炎和慢性前列腺炎,取得了良好的效果。%  Verbena swelling has the effect of detoxification, blood stasis, diuresis, treating chronic nephritis and chronic prostatitis with verbena, and achieved good results.

  20. Insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations

    Energy Technology Data Exchange (ETDEWEB)

    Kotsikoris, Ioannis, E-mail: gkotsikoris@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Zygomalas, Apollon, E-mail: azygomalas@upatras.gr [Department of General Surgery, University Hospital of Patras (Greece); Papas, Theofanis, E-mail: pfanis@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Maras, Dimitris, E-mail: dimmaras@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Pavlidis, Polyvios, E-mail: polpavlidis@yahoo.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Andrikopoulou, Maria, E-mail: madric@gmail.com [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece); Tsanis, Antonis, E-mail: atsanis@gmail.com [Department of Interventional Radiology, “Erythros Stauros” General Hospital (Greece); Alivizatos, Vasileios, E-mail: valiviz@hol.gr [Department of General Surgery and Artificial Nutrition Unit, “Agios Andreas” General Hospital of Patras (Greece); Bessias, Nikolaos, E-mail: bessias@otenet.gr [Department of Vascular Surgery, “Erythros Stauros” General Hospital (Greece)

    2012-09-15

    Introduction: Central venous catheter placement is an effective alternative vascular access for dialysis in patients with chronic renal failure. The purpose of this study was to evaluate the insertion of central venous catheters for hemodialysis using angiographic techniques in patients with previous multiple catheterizations in terms of efficacy of the procedure and early complications. Materials and methods: Between 2008 and 2010, the vascular access team of our hospital placed 409 central venous catheters in patients with chronic renal failure. The procedure was performed using the Seldinger blind technique. In 18 (4.4%) cases it was impossible to advance the guidewire, and so the patients were transported to the angiography suite. Results: Using the angiographic technique, the guidewire was advanced in order to position the central venous catheter. The latter was inserted into the subclavian vein in 12 (66.6%) cases, into the internal jugular vein in 4 (22.2%) and into the femoral vein in 2 (11.1%) cases. There was only one complicated case with severe arrhythmia in 1 (5.5%) patient. Conclusion: Our results suggest that insertion of central venous catheters using angiographic techniques in hemodialysis patients with previous multiple catheterizations is a safe and effective procedure with few complications and high success rates.

  1. Sarcoidosis, Celiac Disease and Deep Venous Thrombosis: a Rare Association

    Directory of Open Access Journals (Sweden)

    Gökhan Çelik

    2011-11-01

    Full Text Available Sarcoidosis is a multisystem granulomatous disorder of unknown etiology and it may rarely be associated with a second disorder. Celiac disease is an immune-mediated enteropathy characterized with malabsorption caused by gluten intolerance, and several reports indicate an association between celiac disease and sarcoidosis. In addition, although celiac disease is associated with several extraintestinal pathologies, venous thrombosis has been rarely reported. Herein we present a rare case report of a patient with a diagnosis of sarcoidosis, celiac disease and deep venous thrombosis because of the rare association of these disorders. The patient was admitted with abdominal pain, weight loss, chronic diarrhea and a 5-day history of swelling in her right leg. A diagnosis of deep venous thrombosis was achieved by doppler ultrasonographic examination. The diagnosis of celiac disease was made by biopsy of duodenal mucosa and supported with elevated serum level of anti-gliadin IgA and IgG, and a diagnosis of sarcoidosis was achieved by transbronchial needle aspiration from the subcarinal lymph node during flexible bronchoscopy.

  2. Transpleural central venous catheter discovered during thoracotomy

    OpenAIRE

    Ashima Malhotra; Prakash Sharma; Ashvini Kumar; Nikhil Malhotra

    2014-01-01

    We report an uncommon complication of subclavian central venous catheterization, discovered at thoracotomy. The central venous catheter (CVC) was placed by left infraclavicular route after induction of general anesthesia. CVC was secured after aspiration of blood and satisfactory central venous tracing. On thoracotomy, CVC was noticed to traverse the pleural cavity while the tracing was normal. CVC was thus removed consequent to which bleeding from each puncture site was noticed, that were se...

  3. 从瘀论治顽固性失眠%Differentiation and Treatment of the Blood Stasis for Intractable Insomnia

    Institute of Scientific and Technical Information of China (English)

    张副兴; 管斯琪; 胡军旗; 裘生梁

    2015-01-01

    Blood stasis is the result of the long­term insomnia as well as an important cause of insomnia. Blood stasis destroys the context of the heart,brain,liver,blood and the imbalance of Yin and Yang,so insomnia again and again. The classic formula for therapeutic sta­ sis treatment of insomnia is Xuefu Zhuyu Tang. Sedentary and less exercise are the common way of life,often cause the formation of pathological factors such as qi and blood stasis. Insomnia patients with blood stasis become more and more. Accordingly,clinical medi­ cine with Huoxue Huayu Tang to remove blood stasis has good curative effect.%血瘀既是长期失眠的结果,又是造成失眠顽固不愈的重要原因。瘀血阻滞心、脑、肝之脉络,气血运行失畅,卫气出入异常,阴阳失调,故失眠反复不愈。从瘀论治失眠的经典配方为血府逐瘀汤。久坐、少动是目前普遍的生活方式,常造成气滞血瘀等病理因素的形成,失眠的证型中兼有血瘀证的患者越来越多。因此,临床用药上,加用活血化瘀药治疗失眠可取得较好的疗效。

  4. Biomechanopharmacology in Evaluation of Herbs of Activating Blood Circulation to Remove Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    LIAO Fu-long; CAO Jun

    2005-01-01

    Herbs of activating blood circulation to remove blood stasis(ABCRBS) are a category of over 10% in the modern Chinese Pharmacopoeia. A new borderline discipline, biomechanopharmacology, is shaping by the efforts of applying biomechanics in pharmacological studies of ABCRBS herbs. Biomechanics is involved in modeling of blood stasis syndrome (BSS) with mechanical force induced injury and model evaluation by shear stress monitoring for blood coagulation. Investigations showed that tetramethylpyrazine (TMP) contained in Ligusticum chuanxiong Hort and diallyl trisulfide (DT) extracted from garlic demonstrated inhibiting characteristics on vWF mediated platelet activation and thrombus formation occurring under high shear rates. The effect of TMP on shear-induced platelet aggregation might be due to inhibition of calcium channel activity since it showed significant inhibition on intracellular level of calcium demonstrated by laser confocal microscope. The combined effects of TMP and shear stress on rat cerebral microvascular endothelial cell (rCMEC) were investigated by various doses of TMP incorporated with different levels of shear stress generated by a rotational coneplate rheometer. The results indicated that apoptosis of rCMECs could be restrained by a combination of medial level of shear stress with a suitable dose of TMP. To study the influences of shear stress, pressure and TMP on angiogenesis of vascular endothelial cell, cultured rCMEC was pretreated in a flow chamber with independent adjustment for levels of shear stress and pressure, and then 3D cultured on Matrigel. The results indicate that combined effects of shear stress, pressure and TMP may influence angiogenesis significantly. We believe that research on interactions among blood shear stress, secretion of endothelial cell, and pharmacodynamics will be an interesting area of biomechanopharmacology. Herbs of ABCRBS and their extracts for protecting endothelial cells to maintain their normal functions are

  5. Epidemiology and pathophysiology of venous thromboembolism: similarities with atherothrombosis and the role of inflammation.

    Science.gov (United States)

    Riva, Nicoletta; Donadini, Marco P; Ageno, Walter

    2015-06-01

    Venous thromboembolism (VTE) is a multifactorial disease. Major provoking factors (e. g. surgery, cancer, major trauma, and immobilisation) are identified in 50-60 % of patients, while the remaining cases are classified as unprovoked. However, minor predisposing conditions may be detectable in these patients, possibly concurring to the pathophysiology of the disease, especially when co-existing. In recent years, the role of chronic inflammatory disorders, infectious diseases and traditional cardiovascular risk factors has been extensively investigated. Inflammation, with its underlying prothrombotic state, could be the potential link between these risk factors, as well as the explanation for the reported association between arterial and venous thromboembolic events. PMID:25472800

  6. Wartime major venous vessel injuries.

    Science.gov (United States)

    Hudorovic, Narcis

    2008-02-01

    The aim of this study is to declare our experience and to identify the important factors that influence the mortality and morbidity in patients with combat-related penetrating wounds of the abdomen (CR-PWA) with major venous vessel injuries. Twenty-six wounded with combat-related injuries of major abdominal venous vessels, admitted in the University Clinic cardiovascular surgery department during the period from 1 August 1991 through 30 October 1995, were analyzed. Patients with concomitant injured arteries and extra-abdominal injuries (n=150; 85.2%) were excluded from this study. The Penetrating Abdominal Trauma Index (PATI) score for each patient was calculated. Fifteen patients (57.69%) sustained with PATI score greater than 25 died. The mean duration of hospitalization was 16 days (range 0-86). The average hospitalization time for those surviving their complications was 17 days with a PATI of 25 or less, and 43 days with a score more than 25. Three clinical assessments of the long-term outcome were performed after a median of about 3, 5 and 10 years, respectively. Surviving patients (42.31%) were symptom free and had normal Duplex scans as well as no other surgical related complications. Higher PATI scores, postoperative complications and reoperations exert an unfavorable effect on patient outcome. PMID:18006557

  7. Venous thromboembolism in cancer patients

    Directory of Open Access Journals (Sweden)

    Mehmet Fuat Eren

    2013-09-01

    Full Text Available Venous thromboembolism (VTE is a major complication of cancer and represents an important cause of morbidity and mortality. The incidence of VTE is 0.6-7.8% in patients with cancer more than double the incidence of VTE in patients without cancer. The risk of VTE which includes deep venous thrombosis (DVT and pulmonary embolism (PE is increased two to seven fold in patients with cancer. VTE risk is especially high among certain groups such as hospitalized patients with cancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoing major surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity, previous VTE and genetic component are also predisposing factors for VTE. Patients with cancer who develop VTE should be managed multidisciplinary treatment guidelines. The primary goal of thromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancer patients should be treated with therapeutic doses of unfractioned heparin (UFH or low molecular weight heparin (LMWH. Prophylaxis should include cancer patients who underwent major surgery for cancer and patients with a history of VTE.

  8. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi; Bretler, Ditte-Marie; Schmiegelow, Michelle Dalgas; Andersson, Charlotte; Azimi, Aziza; Gislason, Gunnar; Torp-Pedersen, Christian; Olesen, Jonas Bjerring

    2013-01-01

    Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated.......Pregnant women are at an increased risk of venous thromboembolism (VTE). Risk factors for VTE among pregnant women are not sufficiently investigated....

  9. Compression for Primary Prevention, Treatment, and Prevention of Recurrence of Venous Leg Ulcers: An Evidence-and Consensus-Based Algorithm for Care Across the Continuum.

    Science.gov (United States)

    Ratliff, Catherine R; Yates, Stephanie; McNichol, Laurie; Gray, Mikel

    2016-01-01

    Chronic venous insufficiency is a prevalent disease that frequently leads to development of venous leg ulcers. While a number of evidence-based clinical practice guidelines have been developed that provide guidance for clinicians when caring for patients with chronic venous insufficiency, they lack adequate detail concerning selection and application of compression for prevention and management of venous leg ulcers. In order to address this need, the WOCN Society appointed a task force to develop an algorithm for compression for primary prevention, treatment, and prevention of recurrent venous leg ulcers in persons with chronic venous insufficiency. The task force used findings from a scoping literature review to identify current best evidence needed to support decision points and pathways within the algorithm. In addition, the task force convened a panel of 20 clinicians and researchers with expertise in lower extremity venous disorders in order to establish consensus around pathways and decision points within the algorithm lacking robust evidence. Following initial construction of the algorithm, a second interdisciplinary group of expert clinicians established content validity and provided additional qualitative feedback used to complete final revisions of the algorithm. This article reviews the process used to create this landmark algorithm, including generation of the evidence- and consensus-based statements used in its construction, the various pathways, and rich supplemental materials embedded within the algorithm, and the process used to establish content validity. PMID:27163774

  10. Sustaining Behavior Changes Following a Venous Leg Ulcer Client Education Program

    Directory of Open Access Journals (Sweden)

    Charne Miller

    2014-09-01

    Full Text Available Venous leg ulcers are a symptom of chronic insufficiency of the veins. This study considered the sustainability of behavior changes arising from a client focus e-Learning education program called the “Leg Ulcer Prevention Program” (LUPP for people with a venous leg ulcer. Data from two related studies were used to enable a single sample (n = 49 examination of behavior maintenance across an average 8 to 9 months period. Physical activity levels increased over time. Leg elevation, calf muscle exercises, and soap substitute use were seen to fluctuate over the follow up time points. The use of a moisturizer showed gradual decline over time. The provision of a client-focused venous leg ulcer program was associated with behavior changes that had varied sustainability across the evaluation period.

  11. Overview of guidelines for the prevention and treatment of venous leg ulcers: a US perspective

    Directory of Open Access Journals (Sweden)

    White-Chu EF

    2014-02-01

    Full Text Available E Foy White-Chu,1 Teresa A Conner-Kerr2 1Oregon Health and Science University, Portland VA Medical Center, Portland, OR, 2Winston-Salem State University, Department of Physical Therapy, Winston Salem, NC, USA Abstract: Comprehensive care of chronic venous insufficiency and associated ulcers requires a multipronged and interprofessional approach to care. A comprehensive treatment approach includes exercise, nutritional assessment, compression therapy, vascular reconstruction, and advanced treatment modalities. National guidelines, meta-analyses, and original research studies provide evidence for the inclusion of these approaches in the patient plan of care. The purpose of this paper is to review present guidelines for prevention and treatment of venous leg ulcers as followed in the US. The paper further explores evidence-based yet pragmatic tools for the interprofessional team to use in the management of this complex disorder. Keywords: venous insufficiency, varicose ulcer, wound, compression bandages

  12. Preliminary molecular basis of Danggui-buxue-tang on Qi deficiency and blood stasis syndrome

    Institute of Scientific and Technical Information of China (English)

    LIU Ya; LI Xiao-hui

    2008-01-01

    Objective To study the molecular biology mechanism of Danggui-buxue-tang on tonifying Qi and controlling blood circulation through modulation the immune functional genes. Methods Rats were randomly divided into control group, model group, and Danggui-buxue-tang group. Effect of Dang-guibuxue-tang on mRNA expressions of IL-1β, TNF-α, HSP-70, NF-kB, p38MAPK and JNK in blood cells of rats with Qi deficiency and blood stasis were measured with real-time fluorescent quantitative-PCR at 5th, 14th and 28th day. And that in artery wall were determined at the 28th day. NF-kB/p65 and p-c-jun protein expressions in rat artery wall were detected by western blotting as well. Results In model group, TNF-α, IL-1β, NF-kB, HSP-70, p38MAPK and JNK mRNA expression in blood cell increased significantly compared with control group. Compared with model group, mRNA expression of IL-1βand JNK decreased significantly; TNF-α decreased at 5th, 14th day;HSP-70, p38MAPK decreased at 14th, 28th day; NF-kB decreased at 28th day. In model group, TNF-α, IL-1β, NF-kB, p38MAPK and JNK mRNA expression in artery increased compared with control group, excluded HSP-70, and that in Danggui-buxue-tang group decreased significantly. In model group, NF-kB/p65 and p-c-jun protein expression in artery increased compared with control group, and that in Danggui-buxue-tang group decreased significantly. Conclusions The effects of Dang-guibuxuetang on Qi deficiency and blood stasis syndrome was brought from the regulating of cytokine network at multi-link and multi-target, NF-kB, p38MAPK and JNK signal transduction pathways included. Through which the immune system and whole body reached to a functional balance status.

  13. Assessment of blood stasis in left-atrial appendage with electron-beam CT: filling delay in atrial fibrillation

    International Nuclear Information System (INIS)

    The left-atrial appendage (LAA) is the most frequent site of thrombus formation. The most probable reason is its anatomical structure and blood stasis. We hypothesized that peak time delay should occur in the LAA with stagnant blood flow. We measured peak time delay in LAA against left atrium with the flow-mode study of electron-beam CT for 49 patients (including 23 patients with atrial fibrillation [AF]). Volume-mode scannings were also performed to detect intracardiac thrombi. Patients with atrial fibrillation showed a larger value than those with sinus rhythm. Some AF patients with no filling of contrast media into the LAA and/or thrombus showed a larger value than the others. The value obtained by the flow-mode study might have the potential by the flow-mode study might have the potential to assess blood stasis and to predict the jeopardized state in the LAA. (orig.)

  14. Association Between Insulin Resistance and Phlegm Blood Stasis in Hperlipodemia%高脂血症痰瘀证候与胰岛素抵抗的关系

    Institute of Scientific and Technical Information of China (English)

    袁肇凯; 黄献平; 简亚平; 李跃南; 贺福元; 孙贵香

    2004-01-01

    Objective: The purpose of this investigation was to explore the characteristics of insulin resistance existing in the pathological development of phlegm and blood stasis of hyper lipodemia. Method : All the patients of hyper lipodemia were divided into three group:35 cases of the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis,33 cases of the syndrome of spleen-asthenia with accumulation of phlegm and 29 cases of the syndrome of non-phelgm and nom-blood stasis. At the same time 30 casses of normal group were observed. Then the integral of symptomand sign, fasting plasma glucose (FPG), fasting insulin (FINS), insulin sensitive index (ISI), insulin secretion function index(IS), lipid peroxide(LPO) and superoxide dismutase(SOD) were measured and done correlation analysis. Result : In both the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis and the syndrome of spleen-asthenia with accumulation of phlegm there was an increasing tendency of FPG, FINS, IS and LPO from the control group to non-phelgm and non-blood stasis to the syndrome of spleen-asthenia with accumulation of phlegm to the syndrome of obstruction of the channels and collaterals from phlegm and blood stasis, but ISI and SOD decreased by turns.Simultaneously, there was obvious realation between the integral of symptom and sign of accumulation of phlegm and FPG or ISI(AII P < 0.05,0.01). However,the same association existed between the integral of symptom and sign of blood stasis and FINS or ISI(AII P < 0.05,0.01 ), in which the changes of ISI and the degree of correlation were more evident than the former. Conclusion: Insulin resistance has a certain effect on the the phthological development of phlegm and blood stasis.

  15. New trends in healing chronic wounds

    OpenAIRE

    KREJSKOVÁ, Kamila

    2013-01-01

    Basic theoretical bases As a chronic wound is called a secondarily healing wound which despite adequate therapy does not tend to heal for a period of 6-9 weeks. The cause of the chronic wound occurrence and its transformation into an acute wound can be infection, influence of associated diseases, skin top layer microtraumatization or skin necrosis cavity. Among the most frequent types of chronic wounds there are aligned venous ulcerations, arterial rodent ulcers, decubitus ulcers and neuropat...

  16. Age and the means of bypassing stasis are determinants of the intrinsic subtypes of immortalized human mammary epithelial cells

    Directory of Open Access Journals (Sweden)

    Jonathan K Lee

    2015-03-01

    Full Text Available Based on molecular features, breast cancers are grouped into intrinsic subtypes that have different prognoses and therapeutic response profiles. With increasing age, breast cancer incidence increases, with hormone receptor-positive and other luminal-like subtype tumors comprising a majority of cases. It is not known at what stage of tumor progression subtype specification occurs, nor how the process of aging affects the intrinsic subtype. We examined subtype markers in immortalized human mammary epithelial cell lines established following exposure of primary cultured cell strains to a two-step immortalization protocol that targets the two main barriers to immortality: stasis (stress-associated senescence and replicative senescence. Cell lines derived from epithelial cells obtained from non-tumorous pre- and post-menopausal breast surgery tissues were compared. Additionally, comparisons were made between lines generated using two different genetic interventions to bypass stasis: transduction of either an shRNA that down-regulated p16INK4A, or overexpressed constitutive active cyclin D1/CDK2. In all cases, the replicative senescence barrier was bypassed by transduction of c-Myc. Cells from all resulting immortal lines exhibited normal karyotypes. Immunofluorescence, flow cytometry, and gene expression analyses of lineage-specific markers were used to categorize the intrinsic subtypes of the immortalized lines. Bypassing stasis with p16 shRNA in young strains generated cell lines that were invariably basal-like, but the lines examined from older strains exhibited some luminal features such as keratin 19 and estrogen receptor expression. Overexpression of cyclin D1/CDK2 resulted in keratin 19 positive, luminal-like cell lines from both young and old strains, and the lines examined from older strains exhibited estrogen receptor expression. Thus age and the method of bypassing stasis are independent determinants of subtype in immortalized human

  17. Age and the means of bypassing stasis influence the intrinsic subtype of immortalized human mammary epithelial cells.

    Science.gov (United States)

    Lee, Jonathan K; Garbe, James C; Vrba, Lukas; Miyano, Masaru; Futscher, Bernard W; Stampfer, Martha R; LaBarge, Mark A

    2015-01-01

    Based on molecular features, breast cancers are grouped into intrinsic subtypes that have different prognoses and therapeutic response profiles. With increasing age, breast cancer incidence increases, with hormone receptor-positive and other luminal-like subtype tumors comprising a majority of cases. It is not known at what stage of tumor progression subtype specification occurs, nor how the process of aging affects the intrinsic subtype. We examined subtype markers in immortalized human mammary epithelial cell lines established following exposure of primary cultured cell strains to a two-step immortalization protocol that targets the two main barriers to immortality: stasis (stress-associated senescence) and replicative senescence. Cell lines derived from epithelial cells obtained from non-tumorous pre- and post-menopausal breast surgery tissues were compared. Additionally, comparisons were made between lines generated using two different genetic interventions to bypass stasis: transduction of either an shRNA that down-regulated p16(INK4A), or overexpressed constitutive active cyclin D1/CDK2. In all cases, the replicative senescence barrier was bypassed by transduction of c-Myc. Cells from all resulting immortal lines exhibited normal karyotypes. Immunofluorescence, flow cytometry, and gene expression analyses of lineage-specific markers were used to categorize the intrinsic subtypes of the immortalized lines. Bypassing stasis with p16 shRNA in young strains generated cell lines that were invariably basal-like, but the lines examined from older strains exhibited some luminal features such as keratin 19 and estrogen receptor expression. Overexpression of cyclin D1/CDK2 resulted in keratin 19 positive, luminal-like cell lines from both young and old strains, and the lines examined from older strains exhibited estrogen receptor expression. Thus age and the method of bypassing stasis independently influence the subtype of immortalized human mammary epithelial cells

  18. Forty Cases of Tumorous Fever Treated with TCM Method of Removing Blood Heat and Dissipating Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    Jia Yantao; Chen Liang; Jia Yingjie; Sun Yiyu; Chen Jun

    2006-01-01

    @@ The TCM method of removing blood heat and dissipating blood stasis, originated in Treatise on Epidemic Febrile Diseases (温热论) by ancient physician Ye Tianshi (叶天士), was adopted for the cases of epidemic febrile diseases with pathogenic heat invading the ying-blood system. We take this therapeutic method to treat 40 cases of tumorous fever with rather good effect. A report follows.

  19. Oral amino acids and gastric emptying: an investigation of the mechanism of levodopa-induced gastric stasis.

    OpenAIRE

    Waller, D G; Usman, F; Renwick, A G; Macklin, B; George, C F

    1991-01-01

    To investigate possible mechanisms of levodopa-induced gastric stasis, we have studied the effect of other amino acids on gastric emptying. The large neutral amino acid tryptophan delays gastric emptying in the dog at molar concentrations below those required to stimulate duodenal osmoreceptors. In healthy volunteers, we have shown that neither tryptophan nor the small neutral amino acid glycine delayed gastric emptying when given in concentrations similar to those of levodopa which produce g...

  20. Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

    Science.gov (United States)

    Watenpaugh, Donald E.

    1996-01-01

    Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

  1. Mucin-Inspired Thermoresponsive Synthetic Hydrogels Induce Stasis in Human Pluripotent Stem Cells and Human Embryos

    Science.gov (United States)

    2016-01-01

    Human pluripotent stem cells (hPSCs; both embryonic and induced pluripotent) rapidly proliferate in adherent culture to maintain their undifferentiated state. However, for mammals exhibiting delayed gestation (diapause), mucin-coated embryos can remain dormant for days or months in utero, with their constituent PSCs remaining pluripotent under these conditions. Here we report cellular stasis for both hPSC colonies and preimplantation embryos immersed in a wholly synthetic thermoresponsive gel comprising poly(glycerol monomethacrylate)-poly(2-hydroxypropyl methacrylate) [PGMA55-PHPMA135] diblock copolymer worms. This hydroxyl-rich mucin-mimicking nonadherent 3D gel maintained PSC viability and pluripotency in the quiescent G0 state without passaging for at least 14 days. Similarly, gel-coated human embryos remain in a state of suspended animation (diapause) for up to 8 days. The discovery of a cryptic cell arrest mechanism for both hPSCs and embryos suggests an important connection between the cellular mechanisms that evoke embryonic diapause and pluripotency. Moreover, such synthetic worm gels offer considerable utility for the short-term (weeks) storage of either pluripotent stem cells or human embryos without cryopreservation.

  2. Metabolomic Analysis of Clinical Plasma from Cerebral Infarction Patients Presenting with Blood Stasis

    Directory of Open Access Journals (Sweden)

    Min Ho Cha

    2015-01-01

    Full Text Available Blood stasis (BS is characterized as a disorder of blood circulation. In traditional Korean medicine (TKM, it is viewed as a cause factor of diseases such as multiple sclerosis and stroke. This study investigated differences in the plasma metabolites profiles of subjects displaying BS or non-BS patterns. Thirty-one patients with cerebral infarction diagnosed with BS and an equal number of sex- and age-matched non-BS patients were enrolled. Metabolic profiling was performed using UPLC-MS. The ratio of subjects with a rough pulse and purple coloration of the tongue was higher in patients presenting with BS pattern. Through metabolomics analysis, 82 metabolites that differed significantly between the BS and non-BS pattern were identified, and the two groups were significantly separated using an orthogonal partial least square-discriminant analysis model (P<0.001. Of these 82 metabolites, acetyl carnitine, leucine, kynurenine, phosphocholine, hexanoyl carnitine, and decanoyl carnitine were present in significantly higher levels in patients with a BS pattern than those with a non-BS pattern. Our results also demonstrated that seven plasma metabolites, including acyl-carnitines and kynurenine, were associated with a BS pattern, suggesting that variant plasma metabolic profiles may serve as a biomarker for diagnosis of BS in patients with cerebral infarction.

  3. Mucin-Inspired Thermoresponsive Synthetic Hydrogels Induce Stasis in Human Pluripotent Stem Cells and Human Embryos.

    Science.gov (United States)

    Canton, Irene; Warren, Nicholas J; Chahal, Aman; Amps, Katherine; Wood, Andrew; Weightman, Richard; Wang, Eugenia; Moore, Harry; Armes, Steven P

    2016-02-24

    Human pluripotent stem cells (hPSCs; both embryonic and induced pluripotent) rapidly proliferate in adherent culture to maintain their undifferentiated state. However, for mammals exhibiting delayed gestation (diapause), mucin-coated embryos can remain dormant for days or months in utero, with their constituent PSCs remaining pluripotent under these conditions. Here we report cellular stasis for both hPSC colonies and preimplantation embryos immersed in a wholly synthetic thermoresponsive gel comprising poly(glycerol monomethacrylate)-poly(2-hydroxypropyl methacrylate) [PGMA55-PHPMA135] diblock copolymer worms. This hydroxyl-rich mucin-mimicking nonadherent 3D gel maintained PSC viability and pluripotency in the quiescent G0 state without passaging for at least 14 days. Similarly, gel-coated human embryos remain in a state of suspended animation (diapause) for up to 8 days. The discovery of a cryptic cell arrest mechanism for both hPSCs and embryos suggests an important connection between the cellular mechanisms that evoke embryonic diapause and pluripotency. Moreover, such synthetic worm gels offer considerable utility for the short-term (weeks) storage of either pluripotent stem cells or human embryos without cryopreservation. PMID:27163030

  4. A 365-Million-Year-Old Freshwater Community Reveals Morphological and Ecological Stasis in Branchiopod Crustaceans.

    Science.gov (United States)

    Gueriau, Pierre; Rabet, Nicolas; Clément, Gaël; Lagebro, Linda; Vannier, Jean; Briggs, Derek E G; Charbonnier, Sylvain; Olive, Sébastien; Béthoux, Olivier

    2016-02-01

    Branchiopod crustaceans are represented by fairy, tadpole, and clam shrimps (Anostraca, Notostraca, Laevicaudata, Spinicaudata), which typically inhabit temporary freshwater bodies, and water fleas (Cladoceromorpha), which live in all kinds of freshwater and occasionally marine environments [1, 2]. The earliest branchiopods occur in the Cambrian, where they are represented by complete body fossils from Sweden such as Rehbachiella kinnekullensis [3] and isolated mandibles preserved as small carbonaceous fossils [4-6] from Canada. The earliest known continental branchiopods are associated with hot spring environments [7] represented by the Early Devonian Rhynie Chert of Scotland (410 million years ago) and include possible stem-group or crown-group Anostraca, Notostraca, and clam shrimps or Cladoceromorpha [8-10], which differ morphologically from their modern counterparts [1, 2, 11]. Here we report the discovery of an ephemeral pool branchiopod community from the 365-million-year-old Strud locality of Belgium. It is characterized by new anostracans and spinicaudatans, closely resembling extant species, and the earliest notostracan, Strudops goldenbergi [12]. These branchiopods released resting eggs into the sediment in a manner similar to their modern representatives [1, 2]. We infer that this reproductive strategy was critical to overcoming environmental constraints such as seasonal desiccation imposed by living on land. The pioneer colonization of ephemeral freshwater pools by branchiopods in the Devonian was followed by remarkable ecological and morphological stasis that persists to the present day. PMID:26776738

  5. Ecological and evolutionary consequences of benthic community stasis in the very deep sea (>1500 m)

    Science.gov (United States)

    Buzas, Martin A.; Hayek, Lee-Ann C.; Culver, Stephen J.; Hayward, Bruce W.; Osterman, Lisa E.

    2014-01-01

    An enigma of deep-sea biodiversity research is that the abyss with its low productivity and densities appears to have a biodiversity similar to that of shallower depths. This conceptualization of similarity is based mainly on per-sample estimates (point diversity, within-habitat, or α-diversity). Here, we use a measure of between-sample within-community diversity (β1H) to examine benthic foraminiferal diversity between 333 stations within 49 communties from New Zealand, the South Atlantic, the Gulf of Mexico, the Norwegian Sea, and the Arctic. The communities are grouped into two depth categories: 200–1500 m and >1500 m. β1H diversity exhibits no evidence of regional differences. Instead, higher values at shallower depths are observed worldwide. At depths of >1500 m the average β1H is zero, indicating stasis or no biodiversity gradient. The difference in β1H-diversity explains why, despite species richness often being greater per sample at deeper depths, the total number of species is greater at shallower depths. The greater number of communities and higher rate of evolution resulting in shorter species durations at shallower depths is also consistent with higher β1H values.

  6. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

    Meyer-Olesen, Christine L; Nielsen, Sune F; Nordestgaard, Børge G

    2015-01-01

    general population. METHODS: We included 54628 participants from the Copenhagen City Heart Study (1981-83) and the Copenhagen General Population Study (2004-12), all with a measured concentration of IgM rheumatoid factor and without autoimmune rheumatic disease or venous thromboembolism. The main outcome......BACKGROUND: The risk of deep venous thrombosis is increased in patients with rheumatoid arthritis. We tested the hypothesis that increased concentrations of rheumatoid factor are associated with increased risk of deep venous thrombosis in individuals without autoimmune rheumatic disease in the...

  7. Measurement of venous compliance (8-IML-1)

    Science.gov (United States)

    Thirsk, R. B.

    1992-01-01

    The prime objective of this International Microgravity Laboratory (IML-1) investigation is to measure the bulk compliance (distensibility) of the veins in the lower leg before, during, and after spaceflight. It is of particular interest whether venous compliance over the range of both positive and negative transmural pressures (various states of venous distention and collapse) changes throughout the duration of spaceflight. Information concerning the occurrence and character of compliance changes could have implications for the design of improved antigravity suits and further the understanding of inflight and postflight venous hemodynamics.

  8. The possibility for use of venous flaps in plastic surgery

    International Nuclear Information System (INIS)

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required

  9. The possibility for use of venous flaps in plastic surgery

    Science.gov (United States)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.

    2015-11-01

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  10. The possibility for use of venous flaps in plastic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Baytinger, V. F., E-mail: baitinger@mail.tomsknet.ru; Kurochkina, O. S., E-mail: kurochkinaos@yandex.ru; Selianinov, K. V.; Baytinger, A. V. [Research Institute of Microsurgery, Tomsk (Russian Federation); Dzyuman, A. N. [Siberian State Medical University, Tomsk (Russian Federation)

    2015-11-17

    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  11. A novel, non-invasive diagnostic clinical procedure for the determination of an oxygenation status of chronic lower leg ulcers using peri-ulceral transcutaneous oxygen partial pressure measurements: Results of its application in chronic venous insufficiency (CVI [Ein neues, nicht-invasives, klinisch-diagnostisches Verfahren zur Ermittlung eines Sauerstoff-Status chronischer Unterschenkelgeschwüre mit peri-ulzeralen transkutanen Sauerstoffpartialdruck-Messungen: Ergebnisse der Anwendungen bei chronisch-venöser Insuffizienz (CVI

    Directory of Open Access Journals (Sweden)

    Barnikol, Wolfgang K. R.

    2012-06-01

    Full Text Available [english]
    The basis for the new procedure is the simultaneous transcutaneous measurement of the peri-ulceral oxygen partial pressure (tcPO, using a minimum of 4 electrodes which are placed as close to the wound margin as possible, additionally, as a challenge the patient inhales pure oxygen for approximately 15 minutes. In order to evaluate the measurement data and to characterise the wounds, two new oxygen parameters were defined: (1 the oxygen characteristic (K-PO, and (2 the oxygen inhomogeneity (I-PO of a chronic wound. The first of these is the arithmetic mean of the two lowest tcPO measurement values, and the second is the variation coefficient of the four measurement values. Using the K-PO parameter, a grading of wound hypoxia can be obtained. To begin with, the physiologically regulated (and still compensated hypoxia with K-PO values of between 35 and 40 mmHg is distinguished from the pathological decompensated hypoxia with K-PO values of between 0 and 35 mmHg; the first of these still stimulates self-healing (within the limits of the oxygen balance. The decompensated hypoxia can be (arbitrarily divided into “simple” hypoxia (Grade I, intense hypoxia (Grade II and extreme hypoxia (Grade III, with the possibility of intermediate grades (I/II and II/III.Measurements were carried out using the new procedure on the skin of the right inner ankle of 21 healthy volunteers of various ages, and in 17 CVI (chronic venous insufficiency wounds. Sixteen of the 17 CVI wounds (i.e., 94% were found to be pathologically hypoxic, a state which was not found in any of the healthy volunteers. The oxygen inhomogeneity (I-PO of the individual chronic wounds increased exponentially as a function of the hypoxia grading (K-PO, with a 10-fold increase with extreme hypoxia in contrast to a constant value of approximately 14% in the healthy volunteers. This pronounced oxygen inhomogeneity explains inhomogeneous wound healings, resulting in the so

  12. Treatment of hepatic venous stenosis by transfemoral venous balloon dilation following living donor liver transplantation: a case report

    Institute of Scientific and Technical Information of China (English)

    Weiwei Jiang; Yangsui Liu; Lianbao Kong

    2009-01-01

    Hepatic venous stenosis may be a cause of graft failure in living donor liver transplantation (LDLT). Balloon dilation and metallic frame approaches have been used successfully to treat hepatic venous stenosis. Here, we report the effect of transfemoral venous balloon dilation for treating a child with hepatic venous stenosis after LDLT.

  13. Salvage of Intraoperative Deep Inferior Epigastric Perforator Flap Venous Congestion with Augmentation of Venous Outflow: Flap Morbidity and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Oscar Ochoa, MD

    2013-10-01

    Conclusions: Arterial and venous anatomies play unique roles in flap reliability. DIEP flap venous congestion must be treated expeditiously with venous augmentation to relieve venous congestion and mitigate flap morbidity.

  14. Intraneural Venous Malformations of the Median Nerve

    Science.gov (United States)

    González Rodríguez, Alba; Midón Míguez, José

    2016-01-01

    Venous malformations arising from the peripheral nerve are a rare type of vascular malformation. We present the first case of an intraneural venous malformation of the median nerve to be reported in a child and review the previous two cases of median nerve compression due to a venous malformation that have been reported. These cases presented with painless masses in the volar aspect of the wrist or with symptoms suggestive of carpal tunnel syndrome. Clinical suspicion should lead to the use of Doppler ultrasonography as the first-line diagnostic tool. Magnetic resonance imaging and histopathology can confirm the diagnosis, as phleboliths are pathognomonic of venous malformations. Surgical treatment appears to be the only modality capable of successfully controlling the growth of an intraneural malformation. Sclerotherapy and radiotherapy have never been used to treat this type of malformation.

  15. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, W.; Rosendaal, F.R.; Doggen, C.J.M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  16. Prophylaxis for venous thromboembolism: a great global divide between expert guidelines and clinical practice?

    Science.gov (United States)

    Bikdeli, Behnood; Sharif-Kashani, Babak

    2012-03-01

    Our understanding of development and prevention of venous thromboembolism (VTE) has improved dramatically since Virchow described the triad of stasis, hypercoagulability, and endothelial dysfunction during the mid-1800s. A full arsenal of effective pharmacological and mechanical methods can help prevent VTE and many professional organizations have provided extensive evidence-based statements for VTE prophylaxis. Disappointingly, however, VTE has remained the major preventable cause of hospital death. Adherence rate to clinical guidelines is undesirably low. Many real-world patients have also been excluded from VTE prevention trials and hence practice guidelines recommendations. The comprehensive and repetitious formats of many available guidelines also limit their readability and applicability by nonthrombosis specialists. Moreover, some patients suffer from VTE despite complying with the contemporary prophylaxis regimens. Besides, significant heterogeneity exists in thromboprophylaxis practice and pitfalls between different countries. Last but not the least; although many at-risk patients are underprophylaxed, there is evidence to suggest that overprophylaxis (i.e., prescription of thromboprophylaxis in low-risk patients) comprises another important problem. We review the thromboprophylaxis practice and pitfalls around the world and provide recommendations on how the major obstacles can be overcome. PMID:22422329

  17. Pathophysiology of spontaneous venous gas embolism

    Science.gov (United States)

    Lambertsen, C. J.; Albertine, K. H.; Pisarello, J. B.; Flores, N. D.

    1991-01-01

    The use of controllable degrees and durations of continuous isobaric counterdiffusion venous gas embolism to investigate effects of venous gas embolism upon blood, cardiovascular, and respiratory gas exchange function, as well as pathological effects upon the lung and its microcirculation is discussed. Use of N2O/He counterdiffusion permitted performance of the pathophysiologic and pulmonary microstructural effects at one ATA without hyperbaric or hypobaric exposures.

  18. Entrapment of guidewire during central venous catheterization

    Directory of Open Access Journals (Sweden)

    Tarun S.

    2016-07-01

    Full Text Available Central venous catheterization (CVC is common in the setting of ICU for various reasons like monitoring of CVP, fluid administration and vasopressor or drug infusions. Guidewires are routinely used in the Seldinger technique during central venous catheter placement CVC placement is not innocuous as numerous complications may occur, with varying frequency and severity. [Int J Res Med Sci 2016; 4(7.000: 3080-3081

  19. Prevention and treatment of venous ulceration.

    OpenAIRE

    Negus, D.

    1985-01-01

    Venous ulcers are related to incompetence of the direct calf and ankle perforating veins, the majority of which follow deep vein thrombosis. Prevention of the latter by intravenous micro-dose heparin (1 unit/kg/hour) is effective, safe and inexpensive. Its efficacy has been proved in two controlled clinical trials. Venous ulcers have been treated by perforating vein ligation, with saphenous ligation and stripping where necessary, and with the addition of permanent knee-length elastic compress...

  20. Chronic venous disease as a clinical manifestation of tibial osteochondroma

    Directory of Open Access Journals (Sweden)

    Marcelo Fernandes Lima

    2013-06-01

    Full Text Available Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospital to treat an infected lesion on his left foot and complained of edema and paresthesia of the left lower limb.

  1. Chronic venous disease as a clinical manifestation of tibial osteochondroma

    OpenAIRE

    Marcelo Fernandes Lima; Ilidio Almeida Lima; Sergio Luiz Bizerra Oliveira; Vanessa Heinrich Barbosa de Oliveira Lima; Carlos Alexandre de Souza Rocha

    2013-01-01

    Osteochondromas are the most common type of benign tumor of the skeleton. They most frequently affect the distal extremity of the femur, with the tibia being the second most commonly affected long bone. Vascular complications of these lesions are rare, but pseudoaneurysm formation is the most frequently reported of them. In this case report, we describe a case of compression of the popliteal neurovascular bundle by a tibial osteochondroma in a diabetic patient who had been admitted to hospita...

  2. Progressive compression versus graduated compression for the management of venous insufficiency.

    Science.gov (United States)

    Shepherd, Jan

    2016-09-01

    Venous leg ulceration (VLU) is a chronic condition associated with chronic venous insufficiency (CVI), where the most frequent complication is recurrence of ulceration after healing. Traditionally, graduated compression therapy has been shown to increase healing rates and also to reduce recurrence of VLU. Graduated compression occurs because the circumference of the limb is narrower at the ankle, thereby producing a higher pressure than at the calf, which is wider, creating a lower pressure. This phenomenon is explained by the principle known as Laplace's Law. Recently, the view that compression therapy must provide a graduated pressure gradient has been challenged. However, few studies so far have focused on the potential benefits of progressive compression where the pressure profile is inverted. This article will examine the contemporary concept that progressive compression may be as effective as traditional graduated compression therapy for the management of CVI. PMID:27594309

  3. The importance of venous hypertension in the formation of dural arteriovenous fistulas: a case report of multiple fistulas remote from sinus thrombosis

    International Nuclear Information System (INIS)

    Various hypotheses have been reported concerning the pathogenesis of dural arteriovenous fistulas (DAVFs). However, it is still controversial whether sinus thrombosis or venous hypertension has a greater influence on the formation of DAVFs. We present a rare case of multiple DAVFs that developed after sinus thrombosis. Chronic venous hypertension secondary to sinus thrombosis in the left transverse-sigmoid sinus induced the multiple DAVFs, including one in the right cavernous sinus, which was remote from the occluded sinus. This case indicates the importance of venous hypertension in the formation of DAVFs. (orig.)

  4. Venous catheterization with ultrasound navigation

    Energy Technology Data Exchange (ETDEWEB)

    Kasatkin, A. A., E-mail: ant-kasatkin@yandex.ru; Nigmatullina, A. R. [Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation); Urakov, A. L., E-mail: ant-kasatkin@yandex.ru [Institute of Mechanics Ural Branch of Russian Academy of Sciences, T.Baramzinoy street 34, Izhevsk, Russia, 426067, Izhevsk (Russian Federation); Izhevsk State Medical Academy, Kommunarov street, 281, Izhevsk, Russia, 426034 (Russian Federation)

    2015-11-17

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient’s exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  5. Venous catheterization with ultrasound navigation

    Science.gov (United States)

    Kasatkin, A. A.; Urakov, A. L.; Nigmatullina, A. R.

    2015-11-01

    By ultrasound scanning it was determined that respiratory movements made by chest of healthy and sick person are accompanied by respiratory chest rise of internal jugular veins. During the exhalation of an individual diameter of his veins increases and during the breath it decreases down to the complete disappearing if their lumen. Change of the diameter of internal jugular veins in different phases can influence significantly the results of vein puncture and cauterization in patients. The purpose of this research is development of the method increasing the efficiency and safety of cannulation of internal jugular veins by the ultrasound visualization. We suggested the method of catheterization of internal jugular veins by the ultrasound navigation during the execution of which the puncture of venous wall by puncture needle and the following conduction of J-guide is carried out at the moment of patient's exhalation. This method decreases the risk of complications development during catheterization of internal jugular vein due to exclusion of perforating wound of vein and subjacent tissues and anatomical structures.

  6. Increased transvascular escape rate of albumin during experimental portal and hepatic venous hypertension in the pig. Relation to findings in patients with cirrhosis of the liver

    DEFF Research Database (Denmark)

    Henriksen, J H; Parving, H H; Christiansen, Lasse; Winkler, K; Lassen, N A

    1981-01-01

    during regional venous congestion in the infradiaphragmatic area. Balloon catheters were placed in the portal vein (infrahepatic portal congestion) and in the inferior vena cava above (suprahepatic caval congestion) and below (infrahepatic caval congestion) the outlets of the hepatic veins. TERalb was on...... the average 13% IVMalb.h-1 under basal pressure conditions. TERalb rose significantly (p less than 0.01) during suprahepatic caval and infrahepatic portal congestion to an average of 29 and 19% IVMalb.h-1, respectively. TERalb was positively correlated to the portal pressure (r = 0.75, P less than 0.......001). Only a minor increment in TERalb was found during infrahepatic caval congestion. The hepatic share of the increasedTERalb during stasis above the hepatic veins was estimated to be threefold that of the extrahepatic splanchnic area. Our results point to filtration of protein, predominantely through the...

  7. Increased transvascular escape rate of albumin during experimental portal and hepatic venous hypertension in the pig. Relation to findings in patients with cirrhosis of the liver

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Parving, H H; Christiansen, L; Winkler, K; Lassen, N A

    1981-01-01

    during regional venous congestion in the infradiaphragmatic area. Balloon catheters were placed in the portal vein (infrahepatic portal congestion) and in the inferior vena cava above (suprahepatic caval congestion) and below (infrahepatic caval congestion) the outlets of the hepatic veins. TERalb was on...... the average 13% IVMalb.h-1 under basal pressure conditions. TERalb rose significantly (p less than 0.01) during suprahepatic caval and infrahepatic portal congestion to an average of 29 and 19% IVMalb.h-1, respectively. TERalb was positively correlated to the portal pressure (r = 0.75, P less than 0.......001). Only a minor increment in TERalb was found during infrahepatic caval congestion. The hepatic share of the increased TERalb during stasis above the hepatic veins was estimated to be threefold that of the extrahepatic splanchnic area. Our results point to filtration of protein, predominantely through the...

  8. The role of magnetic resonance imaging in assessing venous vascular abnormalities in the head and neck: a demonstration of cerebrospinal venous insufficiency in a subset of multiple sclerosis patients

    Directory of Open Access Journals (Sweden)

    E. Mark Haacke

    2015-06-01

    Full Text Available The study of chronic cerebrospinal venous insufficiency (CCSVI and its impact on the development and progression of multiple sclerosis (MS remains controversial. Although the initial thrust in evaluating CCSVI was with ultrasound, other modalities including magnetic resonance imaging (MRI have been used to study venous vascular abnormalities. This review focuses on the findings of a number of past MRI studies including a look at a combined study of four previous works with a cohort of 559 MS patients regarding structure and function of the extra-cranial vasculature. Strengths and limitations of each paper are discussed which give insight into conflicting reports of venous abnormalities in MS patients and healthy controls. Guidelines for data acquisition and analysis for future studies related to extra-cranial structure and flow, both arterial and venous, are discussed. This includes the grading of stenosis of the internal jugular veins (IJVs as well as normalized flows through major veins of the neck. The lack of agreement between most studies is likely due to inconsistent data acquisition and incomplete data analysis. Our own work over four independent sites shows good agreement, indicating that there is a high incidence of stenosis and structural venous abnormalities in the MS population and that this change results in reduced outflow of the IJVs and increased collateralization of venous return to the heart compared to healthy controls.

  9. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    OpenAIRE

    Burçin Abud; Kemal Karaarslan; Işıl Kılınç Karaarslan; Süreyya Talay; Soysal Turhan

    2014-01-01

    Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the prese...

  10. Minimal Hepatic Encephalopathy in Patients with Cirrhosis by Measuring Liver Stiffness and Hepatic Venous Pressure Gradient

    OpenAIRE

    Praveen Sharma; Ashish Kumar

    2012-01-01

    Background/Aim : Transient elastography (TE) of liver and hepatic venous pressure gradient (HVPG) allows accurate prediction of cirrhosis and its complications in patients with chronic liver disease. There is no study on prediction of minimal hepatic encephalopathy (MHE) using TE and HVPG in patients with cirrhosis. Patients and Methods : Consecutive cirrhotic patients who never had an episode of hepatic encephalopathy (HE) were enrolled. All patients were assessed by psychometry (number conn...

  11. Three routes to crypsis: Stasis, convergence, and parallelism in the Mastigias species complex (Scyphozoa, Rhizostomeae).

    Science.gov (United States)

    Swift, H F; Gómez Daglio, L; Dawson, M N

    2016-06-01

    Evolutionary inference can be complicated by morphological crypsis, particularly in open marine systems that may rapidly dissipate signals of evolutionary processes. These complications may be alleviated by studying systems with simpler histories and clearer boundaries, such as marine lakes-small bodies of seawater entirely surrounded by land. As an example, we consider the jellyfish Mastigias spp. which occurs in two ecotypes, one in marine lakes and one in coastal oceanic habitats, throughout the Indo-West Pacific (IWP). We tested three evolutionary hypotheses to explain the current distribution of the ecotypes: (H1) the ecotypes originated from an ancient divergence; (H2) the lake ecotype was derived recently from the ocean ecotype during a single divergence event; and (H3) the lake ecotype was derived from multiple, recent, independent, divergences. We collected specimens from 21 locations throughout the IWP, reconstructed multilocus phylogenetic and intraspecific relationships, and measured variation in up to 40 morphological characters. The species tree reveals three reciprocally monophyletic regional clades, two of which contain ocean and lake ecotypes, suggesting repeated, independent evolution of coastal ancestors into marine lake ecotypes, consistent with H3; hypothesis testing and an intraspecific haplotype network analysis of samples from Palau reaffirms this result. Phylogenetic character mapping strongly correlates morphology to environment rather than lineage (r=0.7512, pmorphological similarity in Mastigias spp. clearly results from three separate patterns of evolution: morphological stasis in ocean medusae, convergence of lake morphology across distinct species and parallelism between lake morphologies within species. That three evolutionary routes each result in crypsis illustrates the challenges of interpreting evolutionary processes from patterns of biogeography and diversity in the seas. Identifying cryptic species is only the first step in

  12. [Local tissue hypoxia consequence in the trophic venous ulceration in elderly patients].

    Science.gov (United States)

    Losev, R Z; Zakharova, N B; Burov, Iu A; Iakusheva, E A; Nikitina, V V; Stepanova, T V; Mikul'skaia, E G

    2007-01-01

    This paper analyzes the data of examination and the results of the treatment of 25 patients aged over 80 years (mean age 68.5+/-7 years) suffering from varicosity with long nonhealing trophic ulcers of the distal limb segments (CVI CMP C6) and 20 patients of the same age groups with CVI CEAP stages 3-5. All patients with CVI underwent either full-scope phlebectomy (64.4%) or partial truncal phlebectomy (35.6%), in which the trunk of the greater saphenous vein was stripped up to the upper third of the leg. A TCM-3 outfit (RADIOmeter, Denmark) was employed to measure oxygen tension in limb tissues. Parameters of lipid peroxidation and antioxidant tissue defence were measured intraoperatively in the capillary blood of the fingers as well as in the venous blood withdrawn from the cubital vein and the greater saphenous vein in the lower third of the leg near ulcer). The data obtained evidenced that lipid peroxidation activity was most pronounced in the soft tissues of the lower third of the leg in the group of patients with remarkable chronic venous insufficiency without trophic venous ulcers (GVI CEAP C3-5) and was significantly depleted after formation of varicose ulcers (CVI CEAP C6) associated with remarkable tissue hypoxia (TepO2 1.7-7.0 mm Hg). In all patients with CVI, the syndrome of lipid peroxidation was associated with the lowering of antioxidant defence activity. Patients with trophic venous ulcers had the signs of active inflammation in the soft tissues of the leg. The data obtained in the course of the study made it possible to optimize the treatment policy for elderly patients with trophic venous ulcers. In addition to the lowering of venous hypertension, the treatment included correction of microcirculatory disorders related to local hypoxia. Of special importance was reperfusion attenuation in the postoperative period. PMID:18004264

  13. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  14. 潘智敏教授理瘀的学术经验%Academic Experience of Professor PAN Zhi-min on Curing Stasis

    Institute of Scientific and Technical Information of China (English)

    袁国荣; 潘智敏

    2011-01-01

    Professor PAN Zhi - min is the guidance teacher of the 4th Famous TCM Expert's Academic Experience and doctoral Advisor. She is a student of Professor YANG Ji - sun, the Famous TCM Expert and has a great deal of experience on treating stasis. On the basis of forearms'theory of stasis, professor pan summarized ten types of stasis and stated characteristic of aged disease with stasis. Finally she brought forward suggestions and experienced drugs on curing stasis.%潘智敏教授系第四批全国名老中医药学术经验继承指导老师,博士生导师,得著名中医临床学家杨继荪教授的真传,临证30余年,学验俱丰,其对瘀证的研究,造诣较深.潘智敏教授在继承前人瘀证学说的基础上,总结了瘀证10型,提出了理瘀的对策和经验用药.

  15. Familial risk of venous thromboembolism: a nationwide cohort study

    DEFF Research Database (Denmark)

    Sørensen, H T; Riis, A H; Diaz, L J;

    2011-01-01

    Background: Venous thromboembolism has genetic determinants, but population-based data on familial risks are limited. Objectives: To examine the familial risk of venous thromboembolism. Methods: We undertook a nationwide study of a cohort of patients with deep venous thrombosis or pulmonary...... expected number of venous thromboembolism cases among siblings, using population-specific, gender-specific and age-specific incidence rates. Results: We identified 30 179 siblings of 19 599 cases of venous thromboembolism. The incidence among siblings was 2.2 cases per 1000 person-years, representing a...... with pulmonary embolism. Conclusion: Venous thromboembolism has a strong familial component....

  16. Venous injury in abusive head trauma

    International Nuclear Information System (INIS)

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  17. Venous injury in abusive head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Choudhary, Arabinda K. [Nemours A. I. duPont Hospital for Children, Department of Radiology, Wilmington, DE (United States); Bradford, Ray; Thamburaj, K.; Boal, Danielle K.B. [Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Dias, Mark S. [Hershey Medical Center, Department of Neurosurgery, Hershey, PA (United States)

    2015-11-15

    Abusive head trauma (AHT) is an important cause of serious brain injury in infants and young children who have characteristic clinical and imaging findings that are discordant with the clinical history provided. Recent attention has focused on abnormalities of the cranial venous sinuses and cortical veins, both on MRI and at autopsy. Although many have interpreted these to be secondary to the AHT, some have recently argued that these venous abnormalities represent primary cortical sinus and venous thrombosis that leads secondarily to subdural hemorrhage and secondary brain injury. Direct trauma to the veins and sinuses has been reported at autopsy in AHT, but there has been no systematic study of venous abnormalities in cases of AHT. The purpose of this study was to define the incidence and characteristics of venous and sinus abnormalities in AHT. We included all children <36 months of age who were diagnosed with abusive head trauma between 2001 and 2012 and who had MRI and magnetic resonance (MR) venography as part of their diagnostic workup. We analyzed age, gender and clinical findings. MRI and MR venography were analyzed independently by two neuroradiologists with a focus on abnormalities involving the intracranial veins and venous sinuses. A total of 45 children were included. The median age was 3 months (range 15 days to 31 months) and 28 were boys (62%). Clinical findings included retinal hemorrhage in 71% and extracranial fractures in 55%. CT or MRI demonstrated subdural hemorrhage in 41 (91%); none had subdural effusions. In 31 cases (69%) MR venography demonstrated mass effect on the venous sinuses or cortical draining veins, with either displacement or partial or complete effacement of the venous structures from an adjacent subdural hematoma or brain swelling. We also describe the lollipop sign, which represents direct trauma to the cortical bridging veins and was present in 20/45 (44%) children. Evidence of displacement or compression of cortical veins

  18. Understanding of ZHANG Zhong-jing on stasis-heat pathogenesis under the ‘stasis-heat’ theory proposed professor ZHOU Zhong-ying%基于周仲瑛教授“瘀热”学说探析张仲景瘀热病理思想

    Institute of Scientific and Technical Information of China (English)

    吴洁

    2012-01-01

    基于周仲瑛教授提出“瘀热”学说,认为瘀热是多种外感及内伤疾病发生发展过程中所产生的病理因素,是疾病某一阶段的主要病机.探讨《伤寒杂病论》中瘀热酿脓、瘀热发黄、瘀热发斑、瘀热蓄血等瘀热相搏证的临证表现及选方用药特点.%Based on the 'Stasis-heat' theory proposed by professor ZHOU Zhong-ying, 'Stasis-heat' was a pathological factor that originated from exogenous and endogenous damage in the development and progression of diseases. It could also be the pathogenesis at a certain stage of disease. Discussed clinical symptoms, prescription and drug characteristics on stasis-heat and festering syndrome, stasis-heat and jaundice syndrome, stasis-heat and macula syndrome, stasis-heat and stagnated blood syndrome in Treatise on Febrile and Miscellaneous Diseases.

  19. Discussion of the treatment of membranous dysmenorrhea from blood-stasis%膜样性痛经从瘀论治探讨

    Institute of Scientific and Technical Information of China (English)

    刘萍; 闫蕊花; 郁沙莎; 赵艳艳

    2012-01-01

    论述了膜样性痛经的病因病机和辨证治疗.认为瘀是产生膜样性痛经一系列症状及体征的主要原因,它既是病理产物,又是病理因素,其病机最终演变至瘀.膜样性痛经应该从肾虚、脾虚和肝郁三方面进行辨证治疗.%Etiological factors and pathogenesis of membranous dysmenorrhea are discussed. It is thought that blood-stasis is major cause of membranous dysmenorrhea. Blood-stasis is not a pathological product, and pathological factors.And the pathogenesis of membranous dysmenorrhea would change into blood-stasis. Treatment based on syndrome differentiation of membranous dysmenorrhea should from deficiency of kidney, deficiency of spleen and liver depression.

  20. The Role of Platelets in Venous Thromboembolism

    DEFF Research Database (Denmark)

    Montoro-García, Silvia; Schindewolf, Marc; Stanford, Sophia; Larsen, Ole Halfdan; Thiele, Thomas

    2016-01-01

    thrombosis are evaluated to assess the role of platelets in VTE. The clinical significance of platelets for VTE risk assessment in specific patient cohorts and their role as a suitable therapeutic target for VTE prevention is acknowledged. The role of platelets in VTE is a promising field for future research.......Multiple factors contribute to the risk of venous thromboembolism (VTE). Platelets have attracted much interest in arterial cardiovascular disease, whereas their role in VTE has received much less attention. Recent evidence suggests that platelets may play a more important role in VTE than...... previously anticipated. This review discusses the mechanisms that link platelets with venous thrombotic disease and their potential applications as novel risk factors for VTE. In addition, animal studies and randomized clinical trials that highlight the potential effect of antiplatelet therapy in venous...

  1. The Role of Platelets in Venous Thromboembolism.

    Science.gov (United States)

    Montoro-García, Silvia; Schindewolf, Marc; Stanford, Sophia; Larsen, Ole Halfdan; Thiele, Thomas

    2016-04-01

    Multiple factors contribute to the risk of venous thromboembolism (VTE). Platelets have attracted much interest in arterial cardiovascular disease, whereas their role in VTE has received much less attention. Recent evidence suggests that platelets may play a more important role in VTE than previously anticipated. This review discusses the mechanisms that link platelets with venous thrombotic disease and their potential applications as novel risk factors for VTE. In addition, animal studies and randomized clinical trials that highlight the potential effect of antiplatelet therapy in venous thrombosis are evaluated to assess the role of platelets in VTE. The clinical significance of platelets for VTE risk assessment in specific patient cohorts and their role as a suitable therapeutic target for VTE prevention is acknowledged. The role of platelets in VTE is a promising field for future research. PMID:26926584

  2. Topical application of amelogenin extracellular matrix protein in non-healing venous ulcers

    Directory of Open Access Journals (Sweden)

    Burçin Abud

    2014-12-01

    Full Text Available Background and Design: Treatment of chronic venous ulcers of the lower extremity is still an important difficulty. The principal treatment of these ulcers includes compression therapy, local wound care and surgery. Unresponsiveness to these standard treatments is a frequent situation with negative effects on life quality and reductions in personal productivity. Therefore, there is a need for new applications to increase the effectiveness of treatment in treatment-resistant cases. In the present study, we retrospectively evaluated the results of topical application of amelogenin extracellular matrix protein in resistant venous ulcers. Materials and Methods: We analyzed the records of patients with treatment-resistant venous ulceration who were treated with amelogenin extracellular matrix protein between June 2011 and December 2012.. Results: 26 patients (21 male and 5 female with a total number of 28 ulcers (24 patients with 1 ulcer, 2 patients with two ulcers were evaluated. The patients were treated with topically applied amelogenin extracellular matrix protein and regional four bandage compression. Bandages were changed weekly. Each cure continued for six weeks. In fourteen patients (15 ulcers, we observed a complete healing by the end of the first cure. In another twelve cases (13 ulcers, the same period resulted with a reduction in wound diameter. We continued to the second cure for these patients. By the end of the second cure, complete healing was achieved in five cases (6 ulcers. Conclusion: Topical application of amelogenin extracellular matrix protein may be considered as an effective therapeutic choice for refractory venous ulcers.

  3. Effects of radiotherapy on central venous ports

    International Nuclear Information System (INIS)

    During radiotherapy of patients with implant able central venous ports we are often afraid of complications resulting from ports damage on the one hand and their interaction with surrounding tissues on the other hand. In experimental conditions venous ports were exposed to radiation. It was found that radiation reflected from a port is negligible and should not put patients at risk. Radiotherapy does not cause any changes within a port chamber, however it substantially affects elasticity of a polyurethane port catheter and to a minimal extent affects silicone catheter. (authors)

  4. Effect of Pingyangmycin on human venous malformation endothelial cells

    Institute of Scientific and Technical Information of China (English)

    Yi Fang Zhao; Zhi Jun Sun; Yu Lin Jia; Jun Jia; Ya Meng Si; Ji Hong Zhao; Wen Feng Zhang

    2008-01-01

    @@ Purpose: Venous malformations are common vascular anomalies with a propensity of the head and neck. Intralesional injection of Pingyangmycin (PYM, bleomycin A5 hydrochloride) is a widely used sclerotherapy method for the treatment of venous malformation.

  5. Human cerebral venous outflow pathway depends on posture and central venous pressure

    DEFF Research Database (Denmark)

    Gisolf, J; van Lieshout, J J; van Heusden, K; Pott, F; Stok, W J; Karemaker, J M

    Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... subjects, before and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R(2) = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the...

  6. Anti-inflammatory and blood stasis activities of essential oil extracted from Artemisia argyi leaf in animals.

    Science.gov (United States)

    Ge, Yue-Bin; Wang, Zhi-Gang; Xiong, Ying; Huang, Xian-Ju; Mei, Zhi-Nan; Hong, Zong-Guo

    2016-07-01

    Artemisia argyi leaf is a well-known species in traditional Chinese medicine. However, the anti-inflammatory and activating blood stasis activities of its essential oil (AAEO) have not been explored in vivo. The present study measured the contents of three chemical components by gas chromatography (GC). The anti-acute inflammatory effects of AAEO were investigated in dimethyl benzene, glacial acetic acid and carrageenan-induced animals through skin administration or by oral gavage, respectively. The effects of AAEO on haemorheology were studied in a rat acute blood stasis model. The contents of eucalyptol, camphor and borneol in AAEO were 254.4, 51.6 and 58.7 mg/g, respectively. All dosages of AAEO by skin administration significantly decreased the swelling in dimethyl benzene-induced ear oedema and carrageenan-induced paw oedema, and reduced the permeability in glacial acetic acid-induced abdominal blood capillary (p < 0.01). Meanwhile, haemorheology indexes such as whole blood viscosity and the erythrocyte aggregation index significantly decreased only in the high dosage group. In addition, the effects of AAEO by oral gavage were weaker than skin administration at the medium dose in the experiments. It suggests that AAEO has better absorption bioavailability and pharmacological effects through skin administration due to the better skin permeability of essential oil than gastrointestinal absorption. PMID:26894818

  7. Micrometástasis en el ganglio centinela axilar por cáncer de mama. ¿Es necesaria la linfadenectomía axilar completa?

    OpenAIRE

    Solá Suárez, Montserrat

    2013-01-01

    El significado de la micrometástasis en el ganglio centinela en el control de la enfermedad en las pacientes con cáncer de mama en estadio inicial se plantea como cuestión emergente desde finales de los años 90. Varios estudios observacionales permiten adivinar un escaso valor de la micrometástasis en la evolución de la enfermedad loco-regional y a distancia y más dudoso en la supervivencia de las pacientes. La pregunta de investigación permanece y parece necesario un enfoque experimental par...

  8. Advances of Studies on Mechanisms of Drugs for Activating Blood Circulation and Removing Blood Stasis in Treatment of Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Primary liver cancer is mainly characterized by the mass in hypochondriac region, stabbing pain at a fixative region, tenderness, dim complexion,vascular spider, vein exposure, livid tongue,ecchymosis, taut and uneven pulse and other symptoms of blood stasis. Experimental studies have found that the patient with liver cancer is often accompanied with disturbance of microcirculation,increase of blood viscosity and high blood agglutinative state. Therefore, activating blood circulation to remove blood stasis is clinically an important therapy for primary liver cancer. A great number of studies on the mechanisms have been carried out in China and other countries. The follow is a review about the mechanisms.

  9. Thrombin Avtivable Fibrinolysis Inhibitor in Venous and Arterial Thrombosis

    OpenAIRE

    Bruijne, E.L.E.

    2011-01-01

    textabstractVenous and arterial thromboses are major causes of morbidity and mortality. Venous thrombosis is the result of pathological occlusive clot formation in the veins. It occurs mainly in the deep veins of the leg (deep vein thrombosis), from which parts of the clot frequently embolize to the lungs (pulmonary embolism). Less than 5% of all venous thromboses occur at other sites (e.g. arm or cerebral veins). Rarely occurring, but often life-threathening venous thrombosis is splanchnic v...

  10. Risk factors for a first and recurrent venous thrombosis

    OpenAIRE

    Flinterman, Linda Elisabeth

    2013-01-01

    The aim of this thesis was to identify new risk factors for first and recurrent venous thrombosis of both the upper and lower extremity, and assess the incidence of recurrence and mortality after a first venous thrombosis. An overview was provided of the current literature on risk factors and treatment for a first venous thrombosis of the upper extremity (chapter 2). We investigated the association between levels of coagulation factors, blood group and a first venous thrombosis of the upper e...

  11. Pneumothorax as a complication of central venous catheter insertion

    OpenAIRE

    Tsotsolis, Nikolaos; Tsirgogianni, Katerina; Kioumis, Ioannis; Pitsiou, Georgia; Baka, Sofia; Papaiwannou, Antonis; Karavergou, Anastasia; Rapti, Aggeliki; Trakada, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Karapantzos, Ilias; Karapantzou, Chrysanthi; Barbetakis, Nikos; Zissimopoulos, Athanasios

    2015-01-01

    The central venous catheter (CVC) is a catheter placed into a large vein in the neck [internal jugular vein (IJV)], chest (subclavian vein or axillary vein) or groin (femoral vein). There are several situations that require the insertion of a CVC mainly to administer medications or fluids, obtain blood tests (specifically the “central venous oxygen saturation”), and measure central venous pressure. CVC usually remain in place for a longer period of time than other venous access devices. There...

  12. Obstruction of Venous Drainage Linked to Transient Global Amnesia

    OpenAIRE

    Han, Ke; Chao, A-Ching; Chang, Feng-Chi; Chung, Chih-Ping; Hsu, Hung-Yi; Sheng, Wen-Yung; Wu, Jiang; Hu, Han-Hwa

    2015-01-01

    Abnormal extracranial venous drainage modality has been considered an etiology of transient global amnesia (TGA). Evidence suggests that the transmission of the intrathoracic/intraabdominal pressure during a Valsalva maneuver (VM) is mainly through the vertebral venous system, and patency of internal jugular vein (IJV) is essential for venous drainage and pressure releasing. We hypothesize that obstruction of IJV venous drainage is a contributing factor in TGA pathogenesis. A magnetic resonan...

  13. Chronic Diarrhea

    Science.gov (United States)

    ... infections that cause chronic diarrhea be prevented? Chronic Diarrhea What is chronic diarrhea? Diarrhea that lasts for more than 2-4 ... represent a life-threatening illness. What causes chronic diarrhea? Chronic diarrhea has many different causes; these causes ...

  14. Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

    OpenAIRE

    2010-01-01

    Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

  15. 21 CFR 870.1140 - Venous blood pressure manometer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Venous blood pressure manometer. 870.1140 Section... (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood pressure manometer. (a) Identification. A venous blood pressure manometer is a device attached to a...

  16. 21 CFR 876.5955 - Peritoneo-venous shunt.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Peritoneo-venous shunt. 876.5955 Section 876.5955...) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5955 Peritoneo-venous shunt. (a) Identification. A peritoneo-venous shunt is an implanted device that consists of a catheter and a...

  17. PROPHYLAXIS OF VENOUS THROMBOEMBOLISM IN ORTHOPAEDIC SURGERY

    OpenAIRE

    Leme, Luiz Eugênio Garcez; Sguizzatto, Guilherme Turolla

    2015-01-01

    The relevance of prophylaxis of venous thromboembolism and its complications in orthopedic surgery is increasingly significant. This review discusses the pathophysiology of thrombus formation in general and orthopedic surgery, its incidence, predisposing factors and complications. It also presents an updated presentation and critique of prophylaxis currently available in our environment.

  18. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

    Kjaer, Monica L; Mainz, Jan; Soernsen, Lars T;

    2005-01-01

    and reliable evidence-based quality indicators of venous leg ulcer care. A Scandinavian multidisciplinary, cross-sectional panel of wound healing experts developed clinical quality indicators on the basis of scientific evidence from the literature and subsequent group nominal consensus of the panel...

  19. Nonclinical aspects of venous thrombosis in pregnancy.

    Science.gov (United States)

    Struble, Evi; Harrouk, Wafa; DeFelice, Albert; Tesfamariam, Belay

    2015-09-01

    Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non-animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug-induced venous thrombosis. PMID:26404176

  20. Arterial and Venous Thrombosis in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Andrew D. Blann

    2011-01-01

    Full Text Available The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin, especially in high risk groups (such as those who are immobile and on high dose chemotherapy, may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.

  1. Laser irradiation effect on Staphylococcus aureus and Pseudomonas aeruginosa biofilms isolated from venous leg ulcer.

    Science.gov (United States)

    Baffoni, Marina; Bessa, Lucinda J; Grande, Rossella; Di Giulio, Mara; Mongelli, Matteo; Ciarelli, Antonio; Cellini, Luigina

    2012-10-01

    Chronic wounds, including diabetic foot ulcers, pressure ulcers and venous leg ulcers, represent a significant cause of morbidity in developed countries, predominantly in older patients. The aetiology of these wounds is probably multifactorial, but the role of bacteria in their pathogenesis is still unclear. Moreover, the presence of bacterial biofilms has been considered an important factor responsible for wounds chronicity. We aimed to investigate the laser action as a possible biofilm eradicating strategy, in order to attempt an additional treatment to antibiotic therapy to improve wound healing. In this work, the effect of near-infrared (NIR) laser was evaluated on mono and polymicrobial biofilms produced by two pathogenic bacterial strains, Staphylococcus aureus PECHA10 and Pseudomonas aeruginosa PECHA9, both isolated from a chronic venous leg ulcer. Laser effect was assessed by biomass measurement, colony forming unit count and cell viability assay. It was shown that the laser treatment has not affected the biofilms biomass neither the cell viability, although a small disruptive action was observed in the structure of all biofilms tested. A reduction on cell growth was observed in S. aureus and in polymicrobial biofilms. This work represents an initial in vitro approach to study the influence of NIR laser treatment on bacterial biofilms in order to explain its potentially advantageous effects in the healing process of chronic infected wounds. PMID:22182280

  2. CLINICAL CO RELATION BETWEEN ARTERIAL VERSUS VENOUS AMMONIA LEVELS IN HEPATIC ENCEPHLOPATHY IN CIRRHOSIS OF LIVER

    Directory of Open Access Journals (Sweden)

    Manjunath

    2014-05-01

    Full Text Available : INTRODUCTION: Hepatic encephalopathy is a reversible neuropsychiatry state that complicates liver disease. Pathogenesis of Hepatic Encephalopathy in chronic liver is function is widely accepted to be due to failure of hepatic clearance of toxins products from gut exact toxin involved remains controversial but ammonia is thought to be an important factor. Ammonia levels help both in diagnosis and serve as a guide in treatment. Diagnosis of Hepatic Encephalopathy can be done based on clinical criteria and the severity of Hepatic Encephalopathy can be graded by West Haven Criteria. This criterion is the simplest grading of Hepatic Encephalopathy based on clinical findings. AIMS AND OBJECTIVES: To correlate between Ammonia levels and clinical severity of Hepatic Encephalopathy in Cirrhosis of liver and correlate between Arterial versus venous ammonia levels with severity of Hepatic Encephalopathy. RESULTS: Male patients had higher incidence than females. Severity of hepatic encephalopathy was graded by West Haven grading. Arterial total ammonia and venous ammonia was correlated with the clinical severity of HE. Of the 50 patients 3 had grade 1, 18 had grade 2, 22 had grade 3 and 7 had grade 4. Arterial and venous ammonia levels co related with severity of HE. The highest level of arterial ammonia was seen in grade 3 and grade 4.It was seen that other lab parameters also increased with severity of HE. But were not significant. Serum albumin was inversely co related with severity of HE. CONCLUSIONS: Arterial total ammonia correlated better with the severity of Hepatic Encephalopathy as compared to venous ammonia levels. Venous total ammonia did not correlate with severity of Hepatic Encephalopathy and with arterial ammonia levels.

  3. Indigenous cost-effective peritoneo-venous shunt for refractory ascites.

    Science.gov (United States)

    Marimuthu, K; Kumar, A Suresh; Sabanathan, S; Gowrishankar, A; Kumar, P Sasi; Rajkumar, J S

    2004-01-01

    About 5% of patients with chronic liver disease develop massive refractory ascites. These patients cease to respond to diuretic therapy and may develop prerenal azotemia. There is a small but definite role for the peritoneo-venous shunt in these patients. In our study of 36 patients, managed with locally made, single-valved peritoneo-venous shunts (GSAIMS shunts), shunt failure and complication rates were assessed postoperatively. There is a definite improvement in quality of life with this cost-effective locally made shunt if patients are selected carefully. Long-term follow-up of these patients is not possible because most of these patients succumb to advanced liver disease. PMID:15285240

  4. “补肾健脾、祛痰化瘀”法辨治多囊卵巢综合征%Treatment of Invigorating Kidney and Spleen and Eliminating Phlegm and Removing Blood Stasis Based on Syndrome Differentiation of PCOS

    Institute of Scientific and Technical Information of China (English)

    王昕; 陈旭

    2012-01-01

    多囊卵巢综合征(PCOS)是一种常见的女性内分泌失调性疾病,以高雄激素血症、持续无排卵和卵巢多囊性改变等一系列表现为主要特征.属于妇科疾病中最常见且较复杂的病种之一.肾脾两虚,痰瘀互结是多囊卵巢综合症发病的基本病机,而“补肾健脾、祛痰化瘀”法是治疗多囊卵巢综合征的重要方法.%Polycystic Ovary Syndrome(PCOS) is a common female endocrine disorders,and its main features including a series of performance of hyperandrogenism, chronic anovulation and ovaries cystic changes and so on. And it is the most common gynecological and complicated disease. Deficiency of kidney and spleen as well as entanglement of phlegm and blood stasis is the basic pathogenesis. The method of replenishing kidney and spleen and eliminating phlegm and removing blood stasis is an important method of treating polycystic ovary syndrome.

  5. Evaluation of hepatic venous pulsatility and portal venous velocity with doppler ultrasonography during the puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Pekindil, Goekhan [Department of Radiology, Trakya University School of Medicine, 22030 Edirne (Turkey); Varol, Fuesun G. [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey); Ali Yuece, M. [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey); Yardim, Turgut [Department of Obstetrics and Gynecology, Trakya University School of Medicine, 22030 Edirne (Turkey)

    1999-03-01

    Objective: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. Methods and material: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the 6th and 8th weeks postpartum. Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. Results: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17% had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. Conclusion: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium, these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period.

  6. THE COLONIC TRANSIT TEST IN THE ASSESSMENT OF CHRONIC CONSTIPATION

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    In order to assess colonic motility of chronic constipation, colonic transit test was carried out in 34 patients with chronic constipation and in 20 healthy subjects. 20 radiopaque markers are ingested at 8 am before the day test, and plain abdominal films were obtained at 24 h, 48 h and 72 h. The normal value of colonic transit test was 16(80%), or more markers passed after 72 h. By means of transit time study, 34 constipated patients were classified into 2 groups: 12 normal transit patients and 22 slow transit patients. There was no difference in colonic transit time between normal transit patients and controls (P>0.05). Patients with slow transit had more markers left in right colon, left colon and rectosigmoid colon at 48 h (P<0.01, respectively) and 72 h (P<0.01, respectively). According to the transit index, 22 slow transit patients were divided into 3 types: 10 cases colonic stasis, 8 cases outlet obstruction and 4 cases colorectal stasis. The study suggests that chronic constipated patients have abnormalbilities of colonic transit.

  7. Lymphangiosarcoma arising after 33 years within a background of chronic filariasis: a case report with review of literature.

    Science.gov (United States)

    Krishnamoorthy, Naveen; Viswanathan, Seethalakshmi; Rekhi, Bharat; Jambhekar, Nirmala A

    2012-01-01

    Cutaneous angiosarcoma or lymphangiosarcoma represents an uncommon aggressive tumor known to arise on a background of chronic lymphedema secondary to various etiologies, principally following surgery or irradiation. There have been rarely reported cases of angiosarcoma following infective conditions that eventuate with lymphatic stasis. We report a case of angiosarcoma arising after 33 years within a background of filariasis. Awareness of this association can lead to early diagnosis and appropriate treatment of this potentially fatal malignant tumor. PMID:22211335

  8. Endovascular treatment for intracranial venous sinus thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and risk of endovascular treatment for intracranial venous sinus thrombosis. Methods: Twenty seven patients with intracranial venous sinus thrombosis confirmed by CT, MRI, MRV and/or DSA, from 2004 September to 2006 September, were treated with anticoagulant therapy but without response and then followed by multiple modalities including endovascular treatment. Nineteen of them accepted intravenous thrombolysis and mechanical thrombus maceration, another 5 accepted intravenous thrombolysis, mechanical thrombus maceration and intraarterial thrombolysis and the last 3 with stenting. Results: After thrombolysis, symptoms and signs of 23 patients improved obviously and headache disappeared in 18 of them, but with only mild degree in other 5 and no improvement in 3. Twenty one patients among them achieved recanalization of sinuses completely as confirmed on postprocedural angiography, MRI and MRV studies taken prior to hospital discharge and other 3 achieved recanalization of sinuses partly. Conclusion: Endovascular treatment is an effective and safe measure for potentially catastrophic intracranial dural sinus thrombosis. (authors)

  9. Malposition and complications following venous catheterization

    International Nuclear Information System (INIS)

    Malposition and complications following central venous catheterization largely depend on the site of venous approach. Malpositions are very common after subclavian vein catheterization, and even more common after left jugular vein catheterization. On the contrary, their incidence after right jugular puncture is very low. Among complications, pneumothorax is quate common after subclavian vein catheterization, and migration of the catheter towards the heart after right jugular puncture. Vascular damages may occur in any approach: their early detection on chest radiographs very much depends on a rigorous technique. Radiology plays an important role in the early detection of malposition and complications, which is greatly facilitated by a few ml of contrast medium injected through the catheter

  10. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review will...... condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post....... Early diagnosis and treatment is essential to prevent PTS in primary UEDVT; however, there is no consensus on which treatment is the best. Anticoagulation is still considered the treatment of choice for at least 3-6 months, until Randomized Controlled Trials may have demonstrated otherwise....

  11. Pulmonary Venous Obstruction in Cancer Patients

    OpenAIRE

    Chuang-Chi Liaw; Hung Chang; Tsai-Sheng Yang; Ming-Sheng Wen

    2015-01-01

    Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS) between January 2005 and March 2014. The criteria for inclusion were (1) episodes of shortness of breath; (2) chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3) CT scan demo...

  12. Review of the cost of venous thromboembolism

    OpenAIRE

    Fernandez MM; Hogue S; Preblick R; Kwong WJ

    2015-01-01

    Maria M Fernandez,1 Susan Hogue,1 Ronald Preblick,2 Winghan Jacqueline Kwong2 1RTI-Health Solutions, Market Access and Outcomes Strategy, Research Triangle Park, NC, 2Daiichi Sankyo, Inc., Health Economics & Outcomes Research, Parsippany, NJ, USA Background: Venous thromboembolism (VTE) is the second most common medical complication and a cause of excess length of hospital stay. Its incidence and economic burden are expected to increase as the population ages. We reviewed the recent l...

  13. Endovascular treatment of intracranial venous sinus thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis. Methods: Ten patients with intracranial venous sinus thrombosis, confirmed by CT, MRI, MRV and / or DSA and encountered during the period of Aug. 2005-Aug. 2007, were treated with endovascular management after they failed to respond to anticoagulant therapy. Of ten patients, intravenous thrombolysis and mechanical thrombus maceration were carried out in 6, while intravenous thrombolysis, mechanical thrombus maceration together with intra-arterial thrombolysis were employed in 4. After the treatment, the anticoagulant therapy continued for 6 months. The patients were followed up for 12-29 months (mean 21 months). Results: After the treatment, the clinical symptoms and signs were completely or partially relieved in eight patients, including disappearance of headache (n=6) and relive of headache (n=2). No obvious improvement was found in one patient and linguistic function disturbance was seen in the remaining one. Lumbar puncture showed that the cerebrospinal fluid pressure returned to normal in all patients. Neither recurrence of thrombosis nor new symptom of neuralgic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation. Conclusion: Endovascular treatment is an effective and safe procedure for the potentially catastrophic intracranial venous thrombosis. (authors)

  14. [Anatomic and functional features of venous valves].

    Science.gov (United States)

    Griton, P; Vanet, P; Cloarec, M

    1997-05-01

    The comparison of the venous system in the human organism, and in particular the venous valves of the lower limbs, with studies conducted in animal models helped us to understand better the mechanisms involved in adapting to the upright position and walking. We examined work conducted in several species from the horse to the dog, especially in animals who often take on an upright position such as the chimpanzee and the kangouroo, in search for structures comparable to those in man. Different types of valves can be described in man: flotting valves (bicuspid, pigeon nest valves); reinforced valves (mid-thigh); reinforcing valves (periarticular zone in the knee); finally, "flat" valves which are highly resistant formations but with little anti-back flow action. We also describe valvular structures with muscle cells found in the plantar aspect of the foot and the veins of the quadriceps muscle, these valves may have an active hematopropulsive action (Bassi). These results allowed us to identify certain common points between the structures observed in the posterior legs of certain animals and to propose models for investigating venous diseases. PMID:9480339

  15. Ethanol sclerotherapy of peripheral venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Rimon, U. E-mail: rimonu@sheba.health.gov.il; Garniek, A.; Galili, Y.; Golan, G.; Bensaid, P.; Morag, B

    2004-12-01

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur.

  16. Developmental venous anomaly in the newborn brain

    International Nuclear Information System (INIS)

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  17. [Retinal venous obliteration and general pathology].

    Science.gov (United States)

    Aconiu, M; Mihălaş, G; Nemoianu, C

    1992-01-01

    The study of 148 retinal venous obliterations have shown 81 occlusions of central vein and 67 of I and II venous branch. A number of 90 was for the feminine gender (sex) and 59 for the masculine sex. The average age for the appearance of the venous occlusions was 62 years old, having extreme limits between 36-84 years old. Bilaterality has been for 3 cases. Concerning the associated medical affections, hypertension was for 67 patients, myocardiosclerosis have been mentioned for 67 patients, atherosclerosis for 21 patients, pulmonary scleroemphisis for 12 patients. Arterial hypertension with its aspersion that is arteriosclerosis are the main factors that have generated retinal circulation modifyings and have led to a degree of arterial insufficiency. Comparing the ophthalmological aspect to the pressure in the ophthalmic artery, most of the patients had a concordance of TACR and the retinal and choroidal angiosclerosis. The oscillometric examination to the inferior members has been effectuated for 21 patients and it has shown diminished values only for 3 cases. The forecast of the disease is still reserved. Following a group of 40 patients having OVR between 5 and 15 years old it has been established an average survival of 6.2 years. It is mentioned that 26% between these have dyed during the first six years. PMID:1520668

  18. Developmental venous anomaly in the newborn brain

    Energy Technology Data Exchange (ETDEWEB)

    Horsch, S. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Helios Klinikum Berlin-Buch, Department of Neonatology, Berlin (Germany); Govaert, P. [Erasmus MC-Sophia Children' s Hospital, Department of Neonatology, Rotterdam (Netherlands); Cowan, F.M. [Hammersmith Hospital, Department of Paediatrics, Imperial College Healthcare NHS Trust, London (United Kingdom); Benders, M.J.N.L.; Groenendaal, F.; Vries, L.S. de [University Medical Centre Utrecht, Wilhelmina Children' s Hospital, Department of Neonatology, Utrecht (Netherlands); Lequin, M.H. [Erasmus MC/Sophia Children' s Hospital, Department of Paediatric Radiology, Rotterdam (Netherlands); Saliou, G. [University Hospital, Department of Neuroradiology, Le Kremlin-Bicetre (France)

    2014-07-15

    Cerebral developmental venous anomaly (DVA) is considered a benign anatomical variant of parenchymal venous drainage; it is the most common vascular malformation seen in the adult brain. Despite its assumed congenital origin, little is known about DVA in the neonatal brain. We report here the first cohort study of 14 neonates with DVA. Fourteen infants (seven preterm) with DVA diagnosed neonatally using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) from three tertiary neonatal units over 14 years are reviewed. DVA was first detected on cUS in 6 and on MRI in 8 of the 14 infants. The cUS appearances of DVA showed a focal fairly uniform area of increased echogenicity, often (86 %) adjacent to the lateral ventricle and located in the frontal lobe (58 %). Blood flow in the dilated collector vein detected by Doppler ultrasound (US) varied between cases (venous flow pattern in ten and arterialized in four). The appearance on conventional MRI was similar to findings in adults. Serial imaging showed a fairly constant appearance to the DVAs in some cases while others varied considerably regarding anatomical extent and flow velocity. This case series underlines that a neonatal diagnosis of DVA is possible with carefully performed cUS and MRI and that DVA tends to be an incidental finding with a diverse spectrum of imaging appearances. Serial imaging suggests that some DVAs undergo dynamic changes during the neonatal period and early infancy; this may contribute to why diagnosis is rare at this age. (orig.)

  19. Ethanol sclerotherapy of peripheral venous malformations

    International Nuclear Information System (INIS)

    Background: venous malformations are congenital lesions that can cause pain, decreased range of movement, compression on adjacent structures, bleeding, consumptive coagulopathy and cosmetic deformity. Sclerotherapy alone or combined with surgical excision is the accepted treatment in symptomatic malformations after failed treatment attempts with tailored compression garments. Objectives: to report our experience with percutaneous sclerotherapy of peripheral venous malformations with ethanol 96%. Patients and methods: 41 sclerotherapy sessions were performed on 21 patients, aged 4-46 years, 15 females and 6 males. Fourteen patients were treated for painful extremity lesions, while five others with face and neck lesions and two with giant chest malformations had treatment for esthetic reasons. All patients had a pre-procedure magnetic resonance imaging (MRI) study. In all patients, 96% ethanol was used as the sclerosant by direct injection using general anesthesia. A minimum of 1-year clinical follow-up was performed. Follow-up imaging studies were performed if clinically indicated. Results: 17 patients showed complete or partial symptomatic improvement after one to nine therapeutic sessions. Four patients with lower extremity lesions continue to suffer from pain and they are considered as a treatment failure. Complications were encountered in five patients, including acute pulmonary hypertension with cardiovascular collapse, pulmonary embolus, skin ulcers (two) and skin blisters. All patients fully recovered. Conclusion: sclerotherapy with 96% ethanol for venous malformations was found to be effective for symptomatic improvement, but serious complications can occur

  20. Metástasis dural como manifestación inicial de cáncer de próstata Dural metastasis as the first manifestation of prostate cancer

    Directory of Open Access Journals (Sweden)

    G. Alcalá-Cerra

    2011-12-01

    Full Text Available Las metástasis del cáncer de próstata en las meninges intracraneales son raras y con frecuencia son confundidas con meningiomas, hematomas epidurales o subdurales crónicos. Usualmente se presentan en pacientes con diagnóstico oncológico conocido en estadios avanzados de la enfermedad y solo en algunos raros casos sus manifestaciones han precedido a la detección del tumor primario. La presentación clínica es inespecífica, sin embargo, por la afinidad de estos tumores por la base del cráneo, constituye un diagnóstico diferencial del compromiso de pares craneales en varones mayores de 70 años. El tratamiento de estas lesiones no ha sido estandarizado y dentro de las opciones terapéuticas están la resección quirúrgica, quimioterapia, radioterapia o la combinación de estas medidas y aún así la supervivencia es corta. Se presenta el caso de un varón de 77 años cuya manifestación inicial del cáncer de próstata fue la sintomatología producida por una lesión metastásica en la duramadre, confirmada por histopatología. Se revisan los aspectos epidemiológicos, clínicos y de imagen más sobresalientes de las metástasis meníngeas del cáncer de próstata.Metastases of prostate cancer to intracranial meninges are rare and often confused with meningiomas or chronic subdural hematomas. These usually occur in patients with a known cancer diagnosis in advanced stages of the disease, and only in some rare cases do its manifestations precede the detection of the primary tumour. The clinical presentation is unspecific. However, due to the affinity of this tumour for the base of the skull, it must be included in the differential diagnosis of men over 70 years of age with cranial nerve palsy. The treatment of these lesions has not been standardized. Within the therapeutic options we find surgical resection, chemotherapy, radiotherapy or a combination of these measures, and yet survival is poor. We present the case of a 77 year old male

  1. Venous Return and Clinical Hemodynamics: How the Body Works during Acute Hemorrhage

    Science.gov (United States)

    Shen, Tao; Baker, Keith

    2015-01-01

    Venous return is a major determinant of cardiac output. Adjustments within the venous system are critical for maintaining venous pressure during loss in circulating volume. This article reviews two factors that are thought to enable the venous system to compensate during acute hemorrhage: 1) changes in venous elastance and 2) mobilization of…

  2. What's new: Management of venous leg ulcers: Treating venous leg ulcers.

    Science.gov (United States)

    Alavi, Afsaneh; Sibbald, R Gary; Phillips, Tania J; Miller, O Fred; Margolis, David J; Marston, William; Woo, Kevin; Romanelli, Marco; Kirsner, Robert S

    2016-04-01

    Venous leg ulcers account for approximately 70% of all leg ulcers and affect 2.2 million Americans annually. After a comprehensive patient and wound assessment, compression therapy remains the cornerstone of standard care. Adjuvant care with topical or systemic agents is used for wounds that do not heal within 4 weeks. Once healed, long-term compression therapy with stockings or surgical intervention will reduce the incidence of recurrence. This continuing medical education article aims to outline optimal management for patients with venous leg ulcers, highlighting the role of a multidisciplinary team in delivering high quality care. PMID:26979355

  3. Examining factors that influence the adoption of health-promoting behaviours among people with venous disease.

    Science.gov (United States)

    Miller, Charne; Kapp, Suzanne; Donohue, Lisa

    2014-04-01

    People living with venous disease are encouraged to make a number of behaviour modifications to facilitate healing and to prevent a recurrence of a venous leg ulcer. This investigation sought to examine factors described in the literature that shape the effectiveness of multi-component education programs and conduct a secondary analysis of data to examine relationships between various health behaviours for people with a venous leg ulcer who participated in a standardised e-learning education program. This study found few statistically significant and typically minor relationships between health behaviours after participants had completed the education program. No significant differences were identified by participant gender, age or need for a carer, for either the number of health behaviours performed after the education or the number of behaviour changes made during the education. Participants performing few of the recommended health-promoting behaviours prior to the education achieved more behaviour change than those already engaged in the sought after activities [F(2,154) = 16·038, P = 0·000]. The notable lack of associations between the performance of the health-promoting behaviours places emphasis on the need for comprehensive investigation of the moderators and mediators of multi-faceted behaviour change to promote wound healing and chronic disease management. PMID:22891981

  4. The effect of the use of ultrasound in the success of peripheral venous catheterisation.

    Science.gov (United States)

    İsmailoğlu, Elif Günay; Zaybak, Ayten; Akarca, Funda Karbek; Kıyan, Selahattin

    2015-04-01

    The aim of this study was to investigate the effect of ultrasound-guided peripheral venous catheterisation in patients where difficulty was experienced in peripheral venous catheterisation. The study was conducted in the emergency department at a university hospital in İzmir Turkey. After obtaining institutional review board approval and written informed consent, 60 patients with a history or suspicion of difficult cannulation were enrolled with 30 patients in traditional and 30 in ultrasound group. In the ultrasound group, peripheral intravenous catheterisation was performed using a portable ultrasound device with 13.5 MHz ultrasound probe and 20 gauge intravenous catheter. The success rate of peripheral venous catheterisation was 30% in the control group and 70% in the treatment group. The success rate was significantly higher among the treatment group. The mean intensity of felt pain was 6.00 ± 1.98 in the control group and 4.77 ± 1.74 in the treatment group. The mean intensity of felt pain was significantly lower in the treatment group. The state of chronic disease affected the success rate in patients in the treatment group. PMID:25175514

  5. Cerebral Venous Thrombosis in Two Patients with Spontaneous Intracranial Hypotension

    OpenAIRE

    Garcia-Carreira, M. C.; D. Cánovas Vergé; Branera, J.; Zauner, M.; J. Estela Herrero; E. Tió; G. Ribera Perpinyà

    2014-01-01

    Although few patients with spontaneous intracranial hypotension develop cerebral venous thrombosis, the association between these two entities seems too common to be simply a coincidental finding. We describe two cases of spontaneous intracranial hypotension associated with cerebral venous thrombosis. In one case, extensive cerebral venous thrombosis involved the superior sagittal sinus and multiple cortical cerebral veins. In the other case, only a right frontoparietal cortical vein was invo...

  6. Effect of peritoneo-venous shunt on portal pressure.

    OpenAIRE

    Samanta, A K; Leevy, C. M.

    1989-01-01

    The cause of variceal bleed after a peritoneo-venous shunt is not known. Portal haemodynamic consequences of a peritoneo-venous shunt are poorly understood. The most critical period after a peritoneo-venous shunt is the early postoperative period when rapid mobilisation of peritoneal fluid occurs. Serial changes in the portal pressure during the early postoperative period have not been recorded. In the present study preoperative wedge hepatic vein (WHV), right atrial (RA) and pulmonary capill...

  7. Antithrombotic Agents in the Prevention and Treatment of Venous Thromboembolism

    Institute of Scientific and Technical Information of China (English)

    包承鑫

    2004-01-01

    @@ Venous thromboembolism is a major health problem,carrying significant morbidity and mortality, with an incidence that exceeds I per 1 000. Independent risk factors for venous thromboembolism include increasing age, male gender, surgery, trauma, hospital or nursing home confinement, neurologic disease with extremity paresis, central venous catheter/transvenous pacemaker, prior superficial vein thrombosis, and varicose, among women, the risk factors include pregnancy, oral contraceptives, and hormone replacement therapy.

  8. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

    OpenAIRE

    Byju, N.; James Jose; Saifudheen, K; V Abdul Gafoor; P Jithendranath

    2012-01-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, ...

  9. Magnetic resonance angiography in the diagnosis of thoracic venous obstruction.

    Science.gov (United States)

    Chang, Y C; Su, C T; Yang, P C; Wang, T C; Chiu, L C; Hsu, J C

    1998-01-01

    The aims of this study were to evaluate the diagnostic value of orthogonal magnetic resonance angiography (MRA) and to compare the results of MRA with those of digital subtraction venography (DSV) in thoracic venous diseases. Ten normal volunteers were evaluated using two-dimensional time-of-flight MRA in three orthogonal planes to determine the image quality of each venous segment. Twelve consecutive patients suspected of having thoracic venous disease were studied with both MRA and DSV. In the normal subjects, the plane perpendicular to the target vein provided the most consistent visualization. Using three orthogonal MRA images, a diagnostic-quality image was obtained in 175 (83%) of 210 venous segments in normal volunteers. In patients with thoracic venous obstructive disease, MRA was more effective than DSV in detecting total (84 vs 54), patent (56 vs 36), stenotic (13 vs 10), and obstructive (15 vs 8) venous segments, poststenotic or postobstructive veins (15 vs 10), thrombosis of the internal jugular vein (7 vs 2), intraluminal thrombus (5 vs 3), and azygos veins (12 vs 2). Using venous segments visible on DVS (n = 54) as the standard, the sensitivity and specificity of MRA were 94% and 100%, respectively, in detecting venous patency, and 100% and 98% in detecting complete venous obstruction. In the shoulder region, the sensitivity and specificity of MRA were 93% and 100%, respectively, in detecting venous patency, and 100% and 97% in detecting venous obstruction. We conclude that MRA with three orthogonal planes can provide relatively complete and reliable venous mapping, without the need for contrast medium. PMID:9481063

  10. Venous Thromboembolism in the Cancer Population: Pathology, Risk, and Prevention

    OpenAIRE

    Hawbaker, Susan

    2012-01-01

    Patients with cancer have an increased risk of developing venous thromboembolism (VTE) and the incidence of these events has been increasing over the past decade. Venous thromboembolic events include both deep venous thrombosis and pulmonary embolism. These events contribute to higher morbidity and mortality rates. Understanding the complex pathogenesis of and risk factors for cancer-associated VTE will help guide advanced practitioners to improve outcomes with prophylaxis. The American Socie...

  11. Venous port catheter dislocation as an unusual cause of pneumonia

    Directory of Open Access Journals (Sweden)

    Umut Serhat Sanrı

    2014-06-01

    Full Text Available The use of central venous port catheter is a very useful method for long-term therapy in patients with malignancy. Catheter insertion technique and maintenance of equipment is very important to the prevention of catheter-related complications. The most frequent complications are deep venous thrombosis, port infection, catheter obstruction. İn this article, pneumonia occurrence after chemotherapy infusion in a patient who has a completely extravasated central venous port catheter discussed.

  12. Effect of age on the biomechanical and microcirculatory properties of the skin in healthy individuals and during venous ulceration

    Directory of Open Access Journals (Sweden)

    Essam H Mattar

    2011-01-01

    Full Text Available Background: With aging there is alteration of elastic properties of the skin and skin-blood flow. Aim: The purpose of this study was to compare age-related changes in selected biomechanical parameters of the skin (skin hardness, skin extensibility, relaxation time constant, τ and subcutaneous microcirculatory quality (SMQ in individuals with and without venous diseases. Materials and Methods: Two groups were studied: the first group was of asymptomatic healthy individuals and the second group included patients with chronic venous insufficiency (CVI and venous ulceration, without edema. Both groups were subdivided to three age categories (21-40, 41-60 and 61-90 years old. Skin hardness was measured by durometer, extensibility and τ were measured using extensometer and SQM was assessed via postural vasoconstrictive response (LDF. Results: Results showed that skin hardness, extensibility, and τ-values were increased, whereas LDF was decreased in the older groups as compared with younger groups. These changes are attributed to alterations in the skin structure and reduced capillaries density networks. Similar behavior was found in the biomechanical and microcirculatory changes in patients with venous ulceration and CVI, but these changes were more increased further in older patients with venous ulceration as compared with older patients with CVI and that can be attribute to more intense response against tissue injury. Conclusions: Since aging elevated skin hardness and extensibility, but lowered vasoconstrictive response in individuals, with and without, venous diseases, we conclude that aging process is likely to cause an accumulation of damaged skin tissues and that could induce an apparent antigen-driven response that altered skin structure and the subsequent biomechanical properties obtained in this study.

  13. Medical image of the week: maggots

    OpenAIRE

    Mosier JM

    2013-01-01

    An 80-year old man presented with pruritic exacerbation of his chronic wound. He had venous stasis ulcers chronically to the lower extremities bilaterally, requiring bandages. He presented with pruritis, but no fevers or pain. The bandage was removed which revealed the maggots (Figure 1).

  14. Medical image of the week: maggots

    Directory of Open Access Journals (Sweden)

    Mosier JM

    2013-12-01

    Full Text Available An 80-year old man presented with pruritic exacerbation of his chronic wound. He had venous stasis ulcers chronically to the lower extremities bilaterally, requiring bandages. He presented with pruritis, but no fevers or pain. The bandage was removed which revealed the maggots (Figure 1.

  15. Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return

    Directory of Open Access Journals (Sweden)

    Ender Odemis

    2011-01-01

    Full Text Available Levoatriocardinal vein (LACV is characterized by an abnormal connection between pulmonary and systemic venous return. This extremely rare cardiac malformation is usually associated with left-sided obstructive lesions including mitral atresia, hypoplastic left-heart syndrome, and abnormal pulmonary venous connection. Patients may have low systemic cardiac output and pulmonary venous obstruction symptoms. In this manuscript, we report a case with LACV and normal pulmonary venous return with absence of any intracardiac pathology. LACV was demonstrated with echocardiography, angiography, and computed tomography. Surgical correction was made successfully.

  16. Levoatriocardinal vein with normal intracardiac anatomy and pulmonary venous return

    International Nuclear Information System (INIS)

    Levoatriocardinal vein (LACV) is characterized by an abnormal connection between pulmonary and systemic venous return. This extremely rare cardiac malformation is usually associated with left-sided obstructive lesions including mitral atresia, hypoplastic left-heart syndrome, and abnormal pulmonary venous connection. Patients may have low systemic cardiac output and pulmonary venous obstruction symptoms. In this manuscript, we report a case with LACV and normal pulmonary venous return with absence of any intracardiac pathology. LACV was demonstrated with echocardiography, angiography, and computed tomography. Surgical correction was made successfully

  17. Memory Bandage for Functional Compression Management for Venous Ulcers

    Directory of Open Access Journals (Sweden)

    Bipin Kumar

    2016-02-01

    Full Text Available In current compression practice for the treatment of chronic venous disorders, there has always been a challenge of controlled compression by a bandage to achieve a particular pressure range in the affected region of the limb. The challenges in compression in the products could be solved if there were the possibility of stress control in fabric. Herein, we are exploiting the newly discovered phenomena, i.e., stress memory, in a memory polymer (MP for the design and investigation of a smart bandage for functional compression benefits. A memory bandage is developed using a blend yarn consisting of MP filaments (segmented polyurethane and nylon filaments. Results showed the possibility to control or manage the internal stress developed in the bandage in wrapped position by simple heating, and thus allowing pressure readjustment externally. Extra pressure generated by the bandage increases with increasing the level of temperature and strain (p < 0.05. The pressure variations also depend on the number of layers and limb circumference (p < 0.05. The memory bandage could have a great potential over existing conventional compression products, as they could give more freedom to govern pressure level whenever needed during the course of compression therapy as a novel wound care management system.

  18. Patterns of the Cranial Venous System from the Comparative Anatomy in Vertebrates: Part II. The Lateral-Ventral Venous System

    OpenAIRE

    Aurboonyawt, T.; Pereira, V.; Kring, T.; Toulgoat, F.; Churojana, A.; Lasjaunias, P.

    2008-01-01

    Comparing the adult submammalian brain with the human embryonic brain, some patterns of venous drainage are quite similar. The veins lying on the lateral surface of the brain in submammals resemble those of the human embryo. In addition, the new longitudinal venous anastomosis ventral to the brain vesicles occurring late in human embryonic development seems to be similar to the late appearance of the basal vein and the ventral brain stem venous plexus found in adult mammals including man. The...

  19. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

    Energy Technology Data Exchange (ETDEWEB)

    Walser, Eric M., E-mail: walser.eric@mayo.edu [Mayo Clinic, Department of Radiology (United States)

    2012-08-15

    The subcutaneous venous access device (SVAD or 'port') is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient's lifestyle. Because of improved materials and catheter technology, today's ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

  20. Venous Access Ports: Indications, Implantation Technique, Follow-Up, and Complications

    International Nuclear Information System (INIS)

    The subcutaneous venous access device (SVAD or “port”) is a critical component in the care of patients with chronic disease. The modern SVAD provides reliable access for blood withdrawal and medication administration with minimal disruption to a patient’s lifestyle. Because of improved materials and catheter technology, today’s ports are lighter and stronger and capable of high-pressure injections of contrast for cross-sectional imaging. The majority of SVAD placement occurs in interventional radiology departments due to their ability to provide this service at lower costs, lower, complication rates, and greater volumes. Port-insertion techniques vary depending on the operator, but all consist of catheter placement in the central venous circulation followed by subcutaneous pocket creation and port attachment to the catheter with fixation and closure of the pocket. Venous access challenges occasionally occur in patients with central vein occlusions, necessitating catheterization of collateral veins or port placement in alternate locations. Complications of SVADs include those associated with the procedure as well as short- (<30 days) and long-term problems. Procedural and early complications are quite rare due to the near-universal use of real-time ultrasound guidance for vein puncture, but they can include hematoma, catheter malposition, arrhythmias, and pneumothorax. Late problems include both thrombotic complications (native venous or port-catheter thrombosis) and infections (tunnel or pocket infections or catheter-associated bloodstream infections). Most guidelines suggest that 0.3 infections/1000 catheter days is an appropriate upper threshold for the insertion of SVADs.

  1. Diagnosis and endovascular treatment of multiple cerebral venous and venous sinuses thrombosis

    International Nuclear Information System (INIS)

    Objective: Eighty-five cases with multiple cerebral venous and venous sinuses thrombosis including the diagnosis and endovascular therapy were reported. Methods: The long T2 and short T1 signals in the related regions of multiple venous sinuses on MRI and prolonged blood circulation time of the brain with tortuous dilatation of vein in angiography were the important characteristics for the diagnosis. Of the 85 cases, the treatment procedures were consisted of injecting urokinase intermittently via common carotid artery and intra-sinus contact thrombolysis as well as warfarin intake orally. Results: Intracranial pressure of 80 cases reduced down between 230 and 300 mm H2O, and clinical deficits were markedly improved within 10 days. Re-angiography of 18 cases revealed recanalization partly in 5 cases and circulation time appeared near normal i 8 cases during one week after therapy. Conclusions: Combined intraarterial thrombolysis consecutively with general anticoagulation for the treatment of multiple thrombosis in cerebral venous sinuses may be one of the effective means

  2. 77 FR 10748 - Scientific Information Request on Mechanical Prophylaxis of Venous Thromboembolism (VTE)

    Science.gov (United States)

    2012-02-23

    ... Prophylaxis of Venous Thromboembolism (VTE) AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS... Pharmacologic and Mechanical Prophylaxis of Venous Thromboembolism Among Special Populations Review, which is... review of the evidence for pharmacologic and mechanical prophylaxis of venous thromboembolism (VTE)...

  3. Role of Tissue Factor in Venous Thrombosis

    Science.gov (United States)

    Manly, David A.; Boles, Jeremiah; Mackman, Nigel

    2011-01-01

    Venous thromboembolism (VTE) is a leading cause of morbidity and mortality worldwide. However, the mechanisms by which clots are formed in the deep veins have not been determined. Tissue factor (TF) is the primary initiator of the coagulation cascade and is essential for hemostasis. Under pathological conditions, TF is released into the circulation on small-membrane vesicles termed microparticles (MPs). Recent studies suggest that elevated levels of MPTF may trigger thrombosis. This review provides an overview of the role of TF in VTE. PMID:20690821

  4. [Phlebitogenicity of venous catheters of Vialon].

    Science.gov (United States)

    Fassolt, A

    1985-12-01

    During three days 132 surgical patients with postoperative infusion treatment were checked on the frequency of venous reactions in the arms when catheters/cannulas of 4 different materials were used and the outcome compared. A significant result was obtained in connection with the I-cath catheter made of vialon (a polyurethanelike resin polymer) and the L-cath of polyurethane. Phlebitis was decreased to 27.3% resp. 24.2% - approximately half of its usual frequency - when I-cath of polyvinyl-chloride and FEP-teflon vasofix cannulas were applied (both 51.5%). The different predisposing factors of infusion phlebitis are under discussion. PMID:4093198

  5. Pulmonary arterio-venous micro fistulae - Diagnostic

    International Nuclear Information System (INIS)

    Four patients with pulmonary arterio-venous micro-fistulae - of which two were male (50%) - the ages varying from 10 to 43 (X sup(∼) = 22,7), were studied at the Cardiology Centre of the 6th Ward of Santa Casa da Misericordia Hospital in Rio de Janeiro. They were all basically suffering from Manson's Schistosomiasis, the hepato-splenic form in 3 cases (75%) and the Rendu Osler Weber disease with juvenile cirrhosis in 1 case (25%). All four of them had portal hypertension. The individual cases were clinically evaluate with X-rays, scintillographic and hemodynamic tests. (author)

  6. Metástasis en cuero cabelludo como primera manifestación de cáncer de tiroides mixto folicular-papilar

    Directory of Open Access Journals (Sweden)

    S. Junquera Bañares

    2014-08-01

    Full Text Available La aparición de metástasis a distancia en los cánceres diferenciados de tiroides es poco frecuente, y cuando se detectan en piel, suelen darse en el contexto de una enfermedad diseminada después de muchos años de evolución desde el diagnóstico. Se presenta el caso de una paciente de 77 años, sin enfermedad tiroidea conocida que debutó con una metástasis en región parietooccipital del cuero cabelludo en la que se identificó tejido tiroideo. En la ecografía tiroidea se identificó un nódulo informado como tumor folicular y el estudio de extensión precirugía fue negativo. Se le hizo tiroidectomía total más vaciamiento ganglionar del compartimento central y el estudio AP fue informado de carcinoma mixto folicular-papilar sin afectación ganglionar. En el RCT post-I131 (dosis de 104,7 mCi se detectaron micrometástasis pulmonares, y a los 2 meses de una segunda dosis de I131 (125 mCi, la tiroglobulina fue indetectable. El cáncer tiroideo debe incluirse en el diagnóstico diferencial de las metástasis cutáneas, puesto que su diagnóstico y tratamiento temprano, excepto en los casos de enfermedad muy avanzada, el pronóstico de su hallazgo suele ser más favorable que en el resto de tumores sólidos.

  7. Radiographic signs of non-venous placement of intended central venous catheters in children

    International Nuclear Information System (INIS)

    Central venous catheters (CVCs) are commonly used in children, and inadvertent arterial or extravascular cannulation is rare but has potentially serious complications. To identify the radiographic signs of arterial placement of CVCs. We retrospectively reviewed seven cases of arterially malpositioned CVCs on chest radiograph. These cases were identified through departmental quality-assurance mechanisms and external consultation. Comparison of arterial cases was made with 127 age-matched chest radiographs with CVCs in normal, expected venous location. On each anteroposterior (AP) radiograph we measured the distance of the catheter tip from the right lateral border of the thoracic spine, and the angle of the vertical portion of the catheter relative to the midline. On each lateral radiograph we measured the angle of the vertical portion of each catheter relative to the anterior border of the thoracic spine. When bilateral subclavian catheters were present, the catheter tips were described as crossed, overlapping or uncrossed. On AP radiographs, arterially placed CVCs were more curved to the left, with catheter tip positions located farther to the left of midline than normal venous CVCs. When bilateral, properly placed venous catheters were present, all catheters crossed at the level of the superior vena cava (SVC). When one of the bilateral catheters was in arterial position, neither of the catheters crossed or the inter-catheter crossover distance was exaggerated. On lateral radiographs, there was a marked anterior angulation of the vertical portion of the catheter (mean angle 37 ± 15 standard deviation [SD] in arterial catheters versus 5.9 ± 8.3 SD in normally placed venous catheters). Useful radiographic signs suggestive of unintentional arterial misplacement of vascular catheters include leftward curvature of the vertical portion of the catheter, left-side catheter tip position, lack of catheter crossover on the frontal radiograph, as well as exaggerated

  8. Radiographic signs of non-venous placement of intended central venous catheters in children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Erin C. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2016-02-15

    Central venous catheters (CVCs) are commonly used in children, and inadvertent arterial or extravascular cannulation is rare but has potentially serious complications. To identify the radiographic signs of arterial placement of CVCs. We retrospectively reviewed seven cases of arterially malpositioned CVCs on chest radiograph. These cases were identified through departmental quality-assurance mechanisms and external consultation. Comparison of arterial cases was made with 127 age-matched chest radiographs with CVCs in normal, expected venous location. On each anteroposterior (AP) radiograph we measured the distance of the catheter tip from the right lateral border of the thoracic spine, and the angle of the vertical portion of the catheter relative to the midline. On each lateral radiograph we measured the angle of the vertical portion of each catheter relative to the anterior border of the thoracic spine. When bilateral subclavian catheters were present, the catheter tips were described as crossed, overlapping or uncrossed. On AP radiographs, arterially placed CVCs were more curved to the left, with catheter tip positions located farther to the left of midline than normal venous CVCs. When bilateral, properly placed venous catheters were present, all catheters crossed at the level of the superior vena cava (SVC). When one of the bilateral catheters was in arterial position, neither of the catheters crossed or the inter-catheter crossover distance was exaggerated. On lateral radiographs, there was a marked anterior angulation of the vertical portion of the catheter (mean angle 37 ± 15 standard deviation [SD] in arterial catheters versus 5.9 ± 8.3 SD in normally placed venous catheters). Useful radiographic signs suggestive of unintentional arterial misplacement of vascular catheters include leftward curvature of the vertical portion of the catheter, left-side catheter tip position, lack of catheter crossover on the frontal radiograph, as well as exaggerated

  9. Endovascular treatment of central venous obstruction as a complication of prolonged hemodialysis – Preliminary experience in a tertiary care center

    Science.gov (United States)

    Yadav, Mukesh K; Sharma, Madhurima; Lal, Anupam; Gupta, Vivek; Sharma, Ashish; Khandelwal, Niranjan

    2015-01-01

    Background: Central venous disease is a serious complication in patients undergoing hemodialysis, often presenting with symptoms of venous hypertension. Treatment is aimed to provide symptomatic relief and to maintain hemodialysis access site patency. Aim: To describe our initial experience in the endovascular treatment of central venous stenosis or obstruction in patients undergoing hemodialysis. Settings and Design: This was a retrospective study carried out in a tertiary care center. Study duration was 24 months. Follow-up was variable. Materials and Methods: Eleven patients of chronic renal failure undergoing hemodialysis presented with central vein stenosis or obstruction having ipsilateral vascular access, between July 2012 and July 2014. All the patients underwent endovascular treatment and were analyzed retrospectively. Results and Conclusion: A total of 11 patients (4 male and 7 female) underwent 18 interventions for 13 stenotic segments during a time period of 2 years. Eight stenotic segments were in brachiocephalic vein, three in subclavian vein, and two in axillary veins. The technical success rate for endovascular treatment was 81.8%. Two patients underwent percutaneous transluminal angioplasty (PTA) alone and presented with restenosis later. Balloon angioplasty followed by stenting was done in seven patients, two of which required reintervention during follow-up. We found endovascular treatment safe and effective in treating central venous disease. PMID:26752817

  10. Stasis domains and slip surfaces in the locomotion of a bio-inspired two-segment crawler

    CERN Document Server

    Gidoni, Paolo

    2016-01-01

    We formulate and solve the locomotion problem for a bio-inspired crawler consisting of two active elastic segments (i.e., capable of changing their rest lengths), resting on three supports providing directional frictional interactions. The problem consists in finding the motion produced by a given, slow actuation history. By focusing on the tensions in the elastic segments, we show that the evolution laws for the system are entirely analogous to the flow rules of elasto-plasticity. In particular, sliding of the supports and hence motion cannot occur when the tensions are in the interior of certain convex regions (stasis domains), while support sliding (and hence motion) can only take place when the tensions are on the boundary of such regions (slip surfaces). We solve the locomotion problem explicitly in a few interesting examples. In particular, we show that, for a suitable range of the friction parameters, specific choices of the actuation strategy can lead to net displacements also in the direction of high...

  11. CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION: NEW ASPECTS OF THE DEVELOPMENT AND PROGRESSION OF THE DISEASE

    OpenAIRE

    Klimenko, A. A.; N. A. Shostak; N. A. Demidova; I. V. Novikov

    2014-01-01

    The review presents data on the incidence of chronic thromboembolic pulmonary hypertension after pulmonary thromboembolism and describescongenital and acquired coagulation abnormalities in patients with venous thromboembolism. It considers the potential factors of development of chronic thromboembolic pulmonary hypertension and some medical conditions and diseases, which favors the development of pulmonary hypertension after prior pulmonary thromboembolism.

  12. Compression Stockings for Treating Venous Leg Ulcers

    Directory of Open Access Journals (Sweden)

    J. P. Benigni

    2013-01-01

    Full Text Available Background. In order to treat venous leg ulcers, it is recommended to use high pressure compression (30–40 mmHg at the ankle. Compression stockings which are not operator dependant could be the best option because of their pressure control. However 30–40 mmHg compression stockings are often hard to put on. Putting two lower pressure compression stockings over each other could be a good therapeutic alternative. Objectives. To compare the in vitro pressures given by the manufacturers of 2 antiulcer kits with the in vivo interface pressures measured in healthy subjects and to evaluate the stiffness and friction indices from those kits based on the interface pressure in order to assess their clinical properties. Material and Methods. Using a Kikuhime pressure device, interface pressure was measured in 12 healthy subjects at the reference point B1. One stiffness index (Static Stiffness Index (SSI and a friction index have been calculated. Results. Mediven Ulcer kit gets the recommended pressures whereas Jobst’s Ulcer Care kit does not for treating a venous leg ulcer. Jobst’s Ulcer Care transmits entirely the pressure in relation to a friction index close to 1. Conclusion. This antiulcer kit study underlines that in vivo and in vitro pressures can be different (Jobst’s Ulcer Care kit and Mediven Ulcer kit. In order not to lose pressure, it is important to take into account the friction index when superimposing two stockings.

  13. The cerebral venous system and hypoxia.

    Science.gov (United States)

    Wilson, Mark H; Imray, Christopher H E

    2016-01-15

    Most hypobaric hypoxia studies have focused on oxygen delivery and therefore cerebral blood inflow. Few have studied venous outflow. However, the volume of blood entering and leaving the skull (∼700 ml/min) is considerably greater than cerebrospinal fluid production (0.35 ml/min) or edema formation rates and slight imbalances of in- and outflow have considerable effects on intracranial pressure. This dynamic phenomenon is not necessarily appreciated in the currently taught static "Monro-Kellie" doctrine, which forms the basis of the "Tight-Fit" hypothesis thought to underlie high altitude headache, acute mountain sickness, and high altitude cerebral edema. Investigating both sides of the cerebral circulation was an integral part of the 2007 Xtreme Everest Expedition. The results of the relevant studies performed as part of and subsequent to this expedition are reviewed here. The evidence from recent studies suggests a relative venous outflow insufficiency is an early step in the pathogenesis of high altitude headache. Translation of knowledge gained from high altitude studies is important. Many patients in a critical care environment develop hypoxemia akin to that of high altitude exposure. An inability to drain the hypoxemic induced increase in cerebral blood flow could be an underappreciated regulatory mechanism of intracranial pressure. PMID:26294747

  14. Do we have to anticoagulated patients with cerebral venous thrombosis?

    DEFF Research Database (Denmark)

    Feher, G; Illes, Z; Hargroves, D; Komoly, S

    2016-01-01

    INTRODUCTION: Cerebral venous thrombosis (CVT) is a rare form of venous thromboembolism (VTE). Although anticoagulation is recommended for the initial and long term treatment with regards to thrombotic risks for patients with CVT, the role of anticogalution has not been fully elucidated. The aim of...

  15. Venous aneurysm complicating arteriovenous fistula access and matrix metalloproteinases

    Directory of Open Access Journals (Sweden)

    Serra Raffaele

    2015-01-01

    Full Text Available Introduction: An arteriovenous fistula (AVF for placed for hemodialysis may be burdened by one particular complication-the formation of a venous aneurysm. It has been shown that matrix metalloproteinases (MMPs and neutrophil gelatinase-associated lipocalin (NGAL could represent markers of disease in both venous and arterial vessels.

  16. Septic Mesenteric Venous Thrombophlebitis: A Rare Complication of Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Stylianos Kykalos

    2011-01-01

    Full Text Available Mesenteric venous thrombophlebitis represents a very rare complication of acute appendicitis. Based on the findings of a 45-year-old patient with mesenteric venous thrombophlebitis due to acute appendicitis, we herein describe the diagnostic difficulties and therapeutic options in this uncommon disease. The treatment in our case consisted of simple appendectomy and perioperative anticoagulation therapy.

  17. Central venous catheters and catheter locks in children with cancer

    DEFF Research Database (Denmark)

    Handrup, Mette Møller; Møller, Jens Kjølseth; Schrøder, Henrik

    2013-01-01

    To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC).......To determine if the catheter lock taurolidine can reduce the number of catheter-related bloodstream infections (CRBSI) in pediatric cancer patients with tunneled central venous catheters (CVC)....

  18. Occult pulmonary embolism: a common occurrence in deep venous thrombosis

    International Nuclear Information System (INIS)

    Ventilation-perfusion scans were used in a prospective study to determine the prevalence of occult pulmonary embolus in proven deep venous thrombosis. Fifty-eight patients without symptoms of pulmonary embolism, but with venographically proven deep venous thrombosis, were subjected to chest radiographs, /sup 99m/Tc macroaggregated-albumin perfusion scans, and 133Xe ventilation scans. Of the 49 patients with deep venous thrombosis proximal to the calf veins, 17 (35%) had high-probability scans. Of all 58 patients, only 12 (21%) had normal scans. When the study population was compared with a group of 430 patients described in reports of pulmonary perfusion in asymptomatic persons, a significantly higher percentage of high-probability scans was found in the study population with deep venous thrombosis. Baseline ventilation-perfusion lung scanning is valuable for patients with proven above-knee deep venous thrombosis

  19. Functional total anomalous pulmonary venous connection via levoatriocardinal vein.

    Science.gov (United States)

    Hayashi, Taiyu; Ozawa, Katsusuke; Sugibayashi, Rika; Wada, Seiji; Ono, Hiroshi

    2016-07-01

    We report a fetal case of double outlet right ventricle, mitral atresia, and intact atrial septum. Although the pulmonary veins were connected to the left atrium, pulmonary venous blood drained into the right superior vena cava via the stenotic levoatriocardinal vein (LACV), which resulted in a circulation resembling total anomalous pulmonary venous connection (TAPVC) with pulmonary venous obstruction. Since the pulmonary veins were connected to both the stenotic LACV and the "dead-end" left atrium, the pulmonary venous flow had a to-and-fro pattern along with atrial relaxation and contraction. Postnatal echocardiography and computed tomography confirmed the diagnosis of normally connected but anomalously draining pulmonary veins via the LACV. Surgical creation of an atrial septal defect on the day of birth successfully relieved pulmonary venous obstruction. Normally connected but anomalously draining pulmonary veins via the LACV should be considered for TAPVC differential diagnosis in fetuses with a left-side heart obstruction. PMID:27460400

  20. Association of severity and sex with vasoactive substance and sexual hormone level in patients with vascular dementia in the type of kidney asthenia and blood stasis syndrome

    Institute of Scientific and Technical Information of China (English)

    Jian Du; Jing Cai; Shuanghong Shen

    2006-01-01

    BACKGROUND: Kidney asthenia is the basic cause of the development of vascular dementia (VD). Kidney asthenia lasting for a long time will result in blood stasis. Also, the cause of VD may have relationships with endothelin (ET), nitric oxide (NO), homocysteine (HCY), estrogen (E2), and testosterone (T).OBJECTIVE: To observed clinical curative effect of the kidney tonic, pancreas tonic, and blood tonic with promoting blood circulation components in treating kidney asthenia with blood stasis syndrome of VD.DESIGN : Case controlled study.SETTING: Geriatric Institute of Integrated Medicine, Fujian College of Traditional Chinese Medicine.PARTICIPANTS: A total of 70 patients, including 39 males and 31 females aged 60-80 years, were selected from Department of Neurology, Pingshan Hospital from May 2000 to September 2002. Diagnostic criteria were used for probable VD of the American Psychiatric Association. Diagnostic and Statistical of Manual of Mental Disorder, 4th ed (DSM-Ⅳ), 1994 revised, mini-mental state examination (MMSE), and criteria of kidney asthenia with blood stasis with mixed weak and sthenia syndrome of Guidelines of Clinical Research of New Chinese Medicine in Treating Dementia. According to score of kidney asthenia with blood stasis syndrome, they were classified to three groups: mild (n =22), moderate (n =33) and severe (n =15). All of them with complete chest X-Ray, ECG, blood chemistry and other related examinations, exclusive of cardiovascular, liver, kidney diseases, homeopathy and psychiatry diseases. And hereby we also select 30 normal people as the comparing group, having no substantial diseases in heart, brain, kidney, liver, lung and other main organic systems after medical examination. Of this group, 11 were males and 19 were females, ranging from 62 years old to 78 years old. There were no obvious differences between the above two groups in sex, age, and education level after statistical analysis. All patients observed in Pingxi Hospital

  1. [Ambulatory treatment of deep venous thrombosis].

    Science.gov (United States)

    Metz, D; Hezard, N; Brasselet, C

    2001-11-01

    Conventional treatment of deep venous thrombosis (DVT) has been based, until recently, on non-fractionated heparin by continuous intravenous infusion in hospital until effective anticoagulation could be obtained by oral anticoagulants introduced early. Low molecular weight heparin (LMWH) seems to be as effective and has a better bio-availability, which means that there are fewer adverse effects. This usage has logically led to the increase in the possibilities of treatment of DVT at home. However, certain precautions are necessary, especially the evaluation of the individual patient's risk with this strategy. This requires multidisciplinary collaboration and the respect of strict rules (precise diagnostic objective, hospital admission at the slightest doubt of pulmonary embolism) to demonstrate the value of ambulatory LMWH therapy which would improve patient comfort and allow early mobilisation. PMID:11794978

  2. [The diagnostic scores for deep venous thrombosis].

    Science.gov (United States)

    Junod, A

    2015-08-26

    Seven diagnostic scores for the deep venous thrombosis (DVT) of lower limbs are analyzed and compared. Two features make this exer- cise difficult: the problem of distal DVT and of their proximal extension and the status of patients, whether out- or in-patients. The most popular score is the Wells score (1997), modi- fied in 2003. It includes one subjective ele- ment based on clinical judgment. The Primary Care score 12005), less known, has similar pro- perties, but uses only objective data. The pre- sent trend is to associate clinical scores with the dosage of D-Dimers to rule out with a good sensitivity the probability of TVP. For the upper limb DVT, the Constans score (2008) is available, which can also be coupled with D-Dimers testing (Kleinjan). PMID:26502582

  3. Venous thrombosis after cardiac catheterization in infants

    International Nuclear Information System (INIS)

    Factors influencing the rate of post-catheterization venous thrombosis were studied in 180 infants below one year of age. The initial cardiac catheterization was performed either with cutdown technique or percutaneously. At repeat catheterization on the ipsilateral side presence or absence of thrombosis was noted. The overall thrombosis frequency was higher than previously reported, 15.6%. The rate increased with decreasing weight. An increased rate of thrombosis was also found with indwelling femoral vein catheter left in place for more than 24 hours, and infection. In 6 cases, thrombosis involved only the catheterized side and would have been missed by recatheterization from the contralateral side. It was noteworthy that 9 of the thromboses spared the catheterized vessel and engaged only the vena cava. Among factors not influencing thrombosis rate were age, type of cardiac malformation, cyanosis, early operation, catheterization time or balloon septostomy. Percutaneous or cutdown technique did not influence thrombosis rate. (orig.)

  4. Hepatic venous outflow obstruction: Three similar syndromes

    Institute of Scientific and Technical Information of China (English)

    Ulas Darda Bayraktar; Soley Seren; Yusuf Bayraktar

    2007-01-01

    Our goal is to provide a detailed review of venoocclusive disease (VOD), Budd-Chiari syndrome (BCS),and congestive hepatopathy (CH), all of which results in hepatic venous outflow obstruction. This is the first article in which all three syndromes have been reviewed,enabling the reader to compare the characteristics of these disorders. The histological findings in VOD, BCS,and CH are almost identical: sinusoidal congestion and cell necrosis mostly in perivenular areas of hepatic acini which eventually leads to bridging fibrosis between adjacent central veins. Tender hepatomegaly with jaundice and ascites is common to all three conditions.However, the clinical presentation depends mostly on the extent and rapidity of the outflow obstruction.Although the etiology and treatment are completely different in VOD, BCS, and CH; the similarities in clinical manifestations and liver histology may suggest a common mechanism of hepatic injury and adaptation in response to increased sinusoidal pressure.

  5. Cerebral venous anomalies: Clinical significance of so-called venous angioma

    International Nuclear Information System (INIS)

    In contrast to angiography, MRI not only allows the diagnosis of DVA (developmental venous anomaly, so-called venous angioma), but also shows up cavernomas and other angiographically occult vascular malformations. It also differentiates between DVAs and occult true malformations. This has completely changed the pathological assessment of DVAs. In a retrospective study on 31 patients with angiographically proven DVAs neighbouring cavernoma was a frequent finding (15 patients, 48% group I). Symptoms caused by cavernoma were present in 6 (40%) of these 15 patients. The following associations were also found: Cerebral arterial aneurysm (2), spinal arterio-venous dural fistula (1), dermal haemangioma (1), Klippel-Trenauny syndrome (1). Only 16 (52%) of the 31 cases with DVA were free of associated cavernoma (group II). Only 3 (19%) of these patients with a solitary DVA were symptomatic. In our series we have seen no case of bleeding from a DVA. A DVA is a vascular anomaly characterized, like other anomalies, by reduced resistance and limited capacity for regulation and adaptation. In rare cases this can result in haemodynamic disturbances, thrombosis and ischaemia. Wall rupture with bleeding does not occur in DVA. It must be assumed that bleeding reported in patients with DVAs before the availability of MRI resulted from an associated true vascular malformation in most cases. (orig.)

  6. Duplex correlation phlebography in venous mapping of the upper limbs for artery venous fistulas for hemodialysis

    International Nuclear Information System (INIS)

    When clinical evaluation is not enough,the evaluation of the venous condition of the upper limbs for the realization of angio access for hemodialysis is classically based on phlebography,an invasive,risky method.the appear rance of non invasive techniques such as eco Doppler(duplex) makes it necessary to do research in order to determine the utility of the method and define its indications.The authors analyse 35 venous mappings of the upper limbs by phlebography and duplex and compare its results for the different venous regions.They come to the conclusion that duplex presented the best performance for the hum ero axillary subclavian region,detecting thrombosis with a sensitivity of 100% a specificity of 97% positive predictive value of 50% and negative predictive value of 100%.For superficial axis (radial and superficial ulnar,basilic and cephalic)there is low sensitivity for the determination of presence and permeability of the axis but 100% specificity.Duplex was not useful for the description of veins in order to determine utility for Avf.Finally,the authors make recommendations as regards indications of these para clinical tests

  7. Statins and prevention of venous thromboembolism: Myth or reality?

    Science.gov (United States)

    Gaertner, Sébastien; Cordeanu, Eléna-Mihaela; Nouri, Salah; Mirea, Corina; Stephan, Dominique

    2016-03-01

    The pleiotropic effects of statins, beyond their cholesterol-lowering properties, are much debated. In primary prevention, several observational cohort and case-control studies appear to show that statins reduce the incidence of venous thromboembolism by about 30%. In a single randomized placebo-controlled clinical trial (JUPITER), which included 17,000 patients, rosuvastatin 20mg/day reduced the risk of venous thromboembolism by 43%. However, these patients were at low risk of venous thromboembolism, and the frequency of the event was, in principle, low. In secondary prevention, several observational studies and post-hoc analyses of randomized clinical trials have suggested that statins may prevent recurrence of venous thromboembolism. However, none of these studies had enough scientific weight to form the basis of a recommendation to use statins for secondary prevention. The putative preventive effect of statins appears to be independent of plasma cholesterol concentration and could be a pharmacological property of the statin class, although a dose-effect relationship has not been demonstrated. The mechanism through which statins might prevent venous thrombosis is thought to involve their anti-inflammatory and antioxidant effects or perhaps a more specific action, by blocking the degradation of antithrombotic proteins. A mechanism involving the action of statins on interactions between risk factors for atherosclerosis and venous thromboembolism is supported by some studies, but not all. In the absence of firm evidence, statins cannot currently be recommended for primary or secondary prevention of venous thromboembolism. PMID:26778087

  8. Hepatic venous pressure gradients measured by duplex ultrasound

    International Nuclear Information System (INIS)

    AIMS: The hepatic venous pressure gradient is a major prognostic factor in portal hypertension but its measurement is complex and requires invasive angiography. This study investigated the relationship between the hepatic venous pressure gradient and a number of Doppler measurements, including the arterial acceleration index. METHOD: We measured the hepatic venous pressure gradient in 50 fasting patients at hepatic venography. Immediately afterwards, a duplex sonographic examination of the liver was performed at which multiple measurements and indices of the venous and arterial hepatic vasculature were made. RESULTS: Hepatic arterial acceleration was correlated directly with the hepatic venous pressure gradient (r = 0.83, P -2 provided a positive predictive value of 95%, a sensitivity of 65% and a specificity of 95% for detecting patients with severe portal hypertension (hepatic venous pressure gradient > 12 mmHg). A correlation between the hepatic venous pressure gradient and the congestion index of the portal vein velocity (r = 0.45,P = 0.01) and portal vein velocity (r = 0.40,P = 0.044), was also noted. CONCLUSION: Measuring the hepatic arterial acceleration index may help in the non-invasive evaluation of portal hypertension. Tasu, J.-P. et al. (2002)

  9. Postoperative deep venous thrombosis in Japan. Incidence and prophylaxis

    International Nuclear Information System (INIS)

    The incidence of postoperative deep venous thrombosis was investigated using the iodine-125-fibrinogen method in 256 patients undergoing major surgery. Deep venous thrombosis was found in 49 patients (15.3 percent), and nonfatal pulmonary embolism developed in one of seven patients in whom the thrombus extended to the popliteal vein. The same investigation was performed in 110 patients who wore a graduated compression stocking on one leg, with the other leg serving as a control. Deep venous thrombosis was found in 4 of 110 stockinged legs (3.6 percent) and in 16 of 110 control legs (14.5 percent). The incidence of deep venous thrombosis decreased significantly in patients who wore the stocking. An increase in femoral venous flow velocity was found in the stockinged legs by the Doppler method. The mean velocity of venous return by xenon-133 clearance was significantly greater in the stockinged legs than in the control legs. These findings were considered to support the efficacy of graduated compression stockings for the prevention of deep venous thrombosis

  10. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    1996-01-01

    and neurohumoral dysregulation found in cirrhosis. Recent studies have shown that the ET system is highly activated in most cirrhotic patients. Circulating ET-1 and ET-3 levels have a positive relation to the severity of the disease and fluid retention, with the highest values recorded in patients...... venous hypertension. In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other......This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...

  11. Endothelins in chronic liver disease

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    1996-01-01

    This review describes recent progress in the accumulation of knowledge about the endothelins (ETs), a family of vasoactive 21-amino acid polypeptides, in chronic liver disease. Particular prominence is given to the dynamics of ET-1 and ET-3 and their possible relation to the disturbed circulation...... with functional renal failure. Studies on liver biopsies have revealed synthesis of ET-1 in hepatic endothelial and other cells, and recent investigations have identified the hepatosplanchnic system as a major source of ET-1 and ET-3 spillover into the circulation, with a direct relation to portal...... venous hypertension. In addition, marked associations with disturbance of systemic haemodynamics and with abnormal distribution of blood volume have been reported. Although the pathophysiological importance of the ET system in chronic liver disease is not completely understood, similarities to other...

  12. Role of sodium tetradecyl sulfate in venous malformations

    Directory of Open Access Journals (Sweden)

    Saraf Sanjay

    2006-01-01

    Full Text Available Venous malformations are one of the commonest anomalies of the vascular tree and their management has always remained a major challenge. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence and complication rate. The author retrospectively analyzed 40 patients of venous malformations who underwent sclerotherapy with sodium tetradecyl sulfate solely or as an adjunct to surgery. The purpose of the study was to evaluate the efficacy and safety of sodium tetradecyl sulfate sclerotherapy in the treatment of venous malformations.

  13. Acute Mesenteric Venous Thrombosis with a Vaginal Contraceptive Ring

    Directory of Open Access Journals (Sweden)

    Wesley Eilbert

    2014-07-01

    Full Text Available Mesenteric venous thrombosis is a rare cause of abdominal pain, which if left untreated may result in bowel infarction, peritonitis and death. The majority of patients with this illness have a recognizable, predisposing prothrombotic condition. Oral contraceptives have been identified as a predisposing factor for mesenteric venous thrombosis in reproductive-aged women. In the last fifteen years new methods of hormonal birth control have been introduced, including a transdermal patch and an intravaginal ring. In this report, we describe a case of mesenteric venous thrombosis in a young woman caused by a vaginal contraceptive ring. [West J Emerg Med. 2014;15(4:395-397.

  14. Venous thromboembolism in cancer patients: risk assessment, prevention and management.

    Science.gov (United States)

    Tukaye, Deepali N; Brink, Heidi; Baliga, Ragavendra

    2016-03-01

    Thrombosis and thromboembolic events contribute to significant morbidity in cancer patients. Venous thrombosis embolism (which includes deep vein thrombosis and pulmonary embolism) accounts for a large percentage of thromboembolic events. Appropriate identification of cancer patients at high risk for venous thromboembolism and management of thromboembolic event is crucial in improving the quality of care for cancer patients. However, thromboembolism in cancer patients is a complex problem and the management has to be tailored to each individual. The focus of this review is to understand the complex pathology, physiology and risk factors that drive the process of venous thrombosis and embolism in cancer patients and the current guidelines in management. PMID:26919091

  15. Smoking, Chronic Wound Healing, and Implications for Evidence-Based Practice

    OpenAIRE

    McDaniel, Jodi C.; Browning, Kristine K.

    2014-01-01

    Chronic wounds are rising in prevalence and creating significant socioeconomic burdens for patients and healthcare systems worldwide. Therefore, it is now more important than ever that clinicians follow evidence-based guidelines for wound care when developing personalized treatment plans for their patients with chronic wounds. Evidence-based guidelines for treating venous leg ulcers, diabetic foot ulcers, and pressure ulcers, the 3 main categories of chronic wounds, focus primarily on biologi...

  16. Study on Blood Coagulant/Fibrinolytic Activity at Plasma andMonocytic Levels in Coronary Heart Disease Patients withBlood-Stasis Syndrome of Traditional Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To explore and compare the changes of coagulant/fibrinolytic activity in coronary heart disease (CHD) patients with Blood Stasis Syndrome of TCM and evaluate the roles of these changes. Methods: Eighty patients of CHD were divided into two groups by Syndrome Differentiation of TCM, the Blood-Stasis (BS) group (30 cases) and the non-Blood-Stasis (NBS) group (50 cases, including 27 cases of Phlegm-Dampness Syndrome and 23 cases of Qi-Stagnation Syndrome); and 20 healthy persons were enrolled as normal control group. Tissue type plasminogen activator (t-PA) and its inhibitor (PAI-1) in plasma and in human peripheral blood monocyte cell (PBMC), as well as the procoagulant activity (PCA) in PBMC were measured by chromogenic substrate method. Results: The plasma PAI-1 activity and PCA of PBMC in the BS group were significantly higher than those in the NBS group and the normal control group (P<0.01). PAI-1 activity of PBMC in the two groups of CHD patients was higher than those in the normal control group significantly (P<0.01), but no significant difference was found between the BS group and the NBS group (P>0.05). The difference of plasma t-PA activity between the two groups of CHD was insignificant. The PBMC t-PA activity in the BS group was lower than that in the NBS and normal control groups (P<0.01). Conclusion: In the CHD patients with BS, the PBMC PCA was increased and the fibrinolytic activity at both plasma and monocyte levels lowered significantly, these changes in coagulant/fibrinolytic activity may be the important pathologic factors in forming BS which suggests that CHD patients with BS were in the prothrombotic state.

  17. Metástasis mandibular de adenocarcinoma gástrico: Presentación de un caso Mandibular metastases of gastric adenocarcinoma: A case report

    Directory of Open Access Journals (Sweden)

    J. Ferreras Granado

    2007-10-01

    Full Text Available Los tumores malignos de la cavidad oral y mandíbula representan aproximadamente un 5% de todas las neoplasias malignas del cuerpo, y sólo entre el 1 y el 4% son consideradas como metástasis. Tienen su localización más frecuente a nivel de la mandíbula (80%, fundamentalmente en la región molar. Las metástasis mandibulares, cuando aparecen, suelen tener su origen en tumores primarios que asientan en la mama, pulmón, riñón, tiroides, intestinos y próstata; y con menor frecuencia en el estómago, testículos y vesícula biliar. Suelen afectar a pacientes de edad avanzada (4ª-7ª décadas de la vida sin predilección por el sexo. El tratamiento en general es paliativo y pasa por el uso de la radioterapia, quimioterapia y hormonoterapia, reservando la cirugía para casos aislados. Describimos un caso de metástasis mandibular en un paciente adulto como primera manifestación clínica de un adenocarcinoma gástrico.Malignant tumors of the mouth and jaws represents approximately 5% of all malignant neoplasms in the body, and only 1-4% are considered to be metastatic. They are most frequently located in the mandible (80%, fundamentally in the molar region. Metastases to the jaws are usually from breast, lung, kidney, thyroid gland, intestines, and prostate gland; and less frequently from stomach, testes, and bladder. They are more frequent in elderly patients (between 4th and 7th decades with no gender differences. Treatment is usually palliative and based on the use of radiotherapy, chemotherapy andhormonal therapy. Surgery is only used in selected cases. A case of mandibular metastases as first sign of malignant disease of gastric adenocarcinoma is reported.

  18. Seizure in Pregnancy Following Cerebral Venous Sinus Thrombosis

    Science.gov (United States)

    Farzi, Farnoush; Abdollahzadeh, Mehrsima; Faraji, Roya; Chavoushi, Tahereh

    2015-01-01

    Introduction: Seizure involves less than 1% of pregnancies; however it is associated with increased maternal and fetal complications. Cerebral venous sinus thrombosis is a rare, but potentially life-threatening cause of seizure during pregnancy, presenting primarily as seizure in 12% - 31.9% of cases. Pregnancy and puerperium are known as the risk factors of cerebral venous sinus thrombosis. Case Presentation: Here is presented a case of seizure after delivery by cesarean section in an otherwise healthy woman. The final diagnosis was cerebral venous sinus thrombosis probably due to hypercoagulable state in pregnancy. Conclusions: If seizure occurs during the peripartum period, along with providing complete cardiovascular and respiratory support, advanced diagnostic measures are needed and cerebral venous sinus thrombosis should be considered as a possible diagnosis. PMID:26161329

  19. Dural arteriovenous fistula with spinal perimedullary venous drainage

    Directory of Open Access Journals (Sweden)

    Xianli Lv

    2011-01-01

    Full Text Available The purpose of this study was to investigate the characteristics of six patients with dural arteriovenous fistula (DAVF with drainage directly into the perimedullary venous system. In five patients with subarachnoid hemorrhage (SAH, cerebral angiography revealed a DAVF with spinal venous drainage located at the petrosal sinus in one, at the tentorium in one, and at the craniocervical junction in four. In the patient with myelopathy, angiographic exploration began with a spinal angiogram. Bilateral vertebral angiography initially failed to demonstrate the fistula, and a tentorial DAVF was established with carotid artery angiography. Patients had no myelopathy when the venous drainage was limited to the cervical cord; myelopathy was present when the venous drainage descended toward the conus medullaris. Diagnosis of a DAVF presenting with myelopathy is more challenging than of those presenting with SAH.

  20. Partial anomalous pulmonary venous return in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Anomalous pulmonary venous return is an uncommon congenital malformation, and may be partial or total. Partial anomalous pulmonary venous return (PAPVR) is more common than total anomalous pulmonary venous return, and is often associated with other congenital cardiac anomalies. Whilst many patients with PAPVR remain asymptomatic, some may present in later age with symptoms related to left-to-right shunt, right heart failure and pulmonary hypertension. We report two cases of PAPVR detected on Computed Tomography Pulmonary Angiogram (CTPA) for the work up of pulmonary hypertension. The cases demonstrate that, although uncommon, partial anomalous pulmonary venous return can be a contributing factor to pulmonary hypertension and pulmonary veins should be carefully examined when reading a CTPA study.

  1. IMPROVING THE RELIABILITY OF VENOUS DOPPLER FLOW MEASUREMENTS: RELEVANCE OF COMBINED ECG, TRAINING AND REPEATED MEASURES

    OpenAIRE

    STAELENS, Anneleen; Tomsin, Kathleen; OBEN, Jolien; Mesens, Tinne; Grieten, Lars; Gyselaers, Wilfried

    2014-01-01

    The nature of venous Doppler waves is highly variable. An additional electrocardiogram (ECG) improves the interpretation of venous Doppler wave characteristics and allows measurement of venous pulse transit time. The purpose of this study was to assess the reproducibility of ECG-guided repeated measurements of venous Doppler flow characteristics before and after sonographer training and the inter-and intra-observer variability. In four groups of 25 healthy women, venous Doppler flow measureme...

  2. Espondilitis tuberculosa no es una metástasis vertebral: diagnóstico diferencial y tratamiento quirúrgico. A propósito de un caso

    OpenAIRE

    Pérez Vergara, S.; Moreno García, I.; Garcés Hernández, M.; Bas Hermida, T.; Bas Hermida, P.

    2011-01-01

    Presentamos el caso de una paciente con dorsalgia y clínica neurológica de varios meses de evolución que ante las pruebas de imagen fue erróneamente diagnosticada de metástasis vertebral sin confirmación previa con biopsia. El deterioro progresivo neurológico y las nuevas pruebas de imagen confirmaron el diagnóstico de tuberculosis vertebral. La paciente fue tratada mediante curetaje, desbridamiento, fusión intersomática y osteosíntesis anterior además del tratamiento médico. Hubo...

  3. Metástasis óseas. Tratamiento convencional a dosis altas versus fraccionamiento no convencional con dosis equivalente. Análisis uni y multivariante

    OpenAIRE

    Gutiérrez Bayard, Lucía

    2006-01-01

    El tratamiento paliativo de las metástasis óseas con Radioterapia Externa, está bien establecido por su eficacia, sin embargo, sigue el debate acerca de la dosis óptima, régimen de fraccionamiento y su duración. En general, en pacientes con una expectativa de vida limitada, se acepta que deberían recibir un tratamiento efectivo en el menor tiempo posible, siendo la toxicidad aguda el principal problema, sobre todo la fractura patológica. La toxicidad a largo plazo es rara vez vista, dado que ...

  4. Melanoma cutáneo con metástasis gástrica. Presentación de un caso

    OpenAIRE

    Jordi Alonso Soto; Teresita Pérez González; Juan González Cansino

    2012-01-01

    El melanoma es una neoplasia maligna producto de la transformación de los melanocitos. Las metástasis en el aparato digestivo pueden ocurrir en un 10 %. Se presenta el caso de un paciente de 70 años de edad, con antecedentes de hipertensión arterial, que llevaba tratamiento regular con enalapril, de ocupación marino mercante, con mucha exposición al sol. En el año 2009 se le diagnosticó un melanoma en piel para lo que recibió tratamiento combinado de cirugía y quimioterapia, se mantuvo estab...

  5. Plasma Metabonomics Analysis of Tumor Patients of Phlegm-Stasis Syndrome%痰瘀证肿瘤患者血浆代谢组学研究

    Institute of Scientific and Technical Information of China (English)

    巴吐尔·买买提明; 哈木拉提·吾甫尔

    2011-01-01

    Objective To study metabonomic changes in plasma of tumor patients of phlegm-stasis syndrome by Chinese medicine and their in vivo metabolic mechanism. Methods 1H nuclear magnetic resonance (NMR) based metabonomic analysis was performed on plasma samples from 356 tumor patients of the phlegmstasis syndrome and 104 tumor patients of the non-phlegm-stasis syndrome, and 50 healthy subjects. The spectrogram integral results were analyzed by orthogonal partial least-squares discriminant analysis (OPLS-DA). Results Compared with healthy subjects, various amino acids including leucine, alanine, citrulline, tyrosine, histidine, arginine, methionine, isoleucine, valine, acetylcysteine, etc. in the plasma of patients of the phlegm-stasis syndrome were significantly lowered (P <0. 05). Glucose, glycoprotein, glutamine, myo-inositol, lactic acid, choline, creatine also significantly decreased ( P < 0. 05). But the plasmal formic acid, acetone, acetic acid, acetoacetate, pyruvate, β-hydrocxy butyrate, carnitine, malonic acid, and unsaturated fatty acid, very low density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) increased in tumor patients of the phlegm-stasis syndrome. Compared with tumor patients of non-phlegm-stasis syndrome, patients of the phlegm-stasis syndrome had obvious lower plasmal contents of leucine, alanine, citrulline, tyrosine, histidine, isoleucine, valine, glutamine, myo-inositol, scyllo-inositol, lactic acid, creatine ( P < 0. 05), higher plasmal contents of acetone, acetoacetate, unsaturated fatty acid, VLDL-C, α-glucose, β-glucose, glycoprotein, and so on ( P<0. 05). Conclusions Tumor patients of the phlegm-stasis syndrome had strengthened in vivo fat metabolism and lowered various amino acids. The decreased antioxidation capacities resulted in aggravated cell membrane injuries. The in vivo metabolic disorder was more severe in tumor patients of the phlegm-stasis syndrome than in tumor patients of the non-phlgem-stasis

  6. Preliminary report on a new concept stent prototype designed for venous implant.

    Science.gov (United States)

    Lugli, M; Maleti, O

    2015-08-01

    Venous obstruction at iliocaval level in both forms, primary and secondary, is a significant cause of severe chronic venous insufficiency. A new therapeutic approach to this pathology emerged with the introduction of stenting procedures that proved effective, leading to good long-term results. However, at present, the majority of implanted stents have been designed for arterial implant and this can pose a limit in particular districts. The purpose of this preliminary acute study was to verify the deliverability and safety of a new stent specially designed for venous-vessel implant. We assess the safety and deliverability of two braided, self-expanding, nickel-titanium stents (Jotec GmbH, Hechingen, Germany) specially designed for endovascular implant in veins. The two stents, despite being based on the same concept, have a different design: stent A presents a proximal tapering shape specially designed to reduce migration, while stent B does not. Both of them are enlarged at their distal extremity and present variable radial force the length of the stent itself, the said force becoming very high in the intermediate segment. Stents were implanted in the internal jugular vein of a sheep, showing optimal deliverability. The completion venography showed the migration of stent B into the right atrium. Stent A maintained its location, confirmed by intravascular ultrasound examination. No scaffolding effect was detected and an adequate adherence and adaptability to the vein wall was obtained. In conclusions, the stent A design matches the characteristics required by vein implants. Stability is achieved even where difficult anatomical conditions apply, such as in the jugular vein. Deployment is easy and precise in a given landing zone. Radial resistive force is very high, as required in specific vein districts, but is also associated with good flexibility. Following this preliminary acute report, further studies are required. PMID:24920424

  7. Modelling of oedemous limbs and venous ulcers using partial differential equations

    Directory of Open Access Journals (Sweden)

    Wilson Michael J

    2005-08-01

    Full Text Available Abstract Background Oedema, commonly known as tissue swelling, occurs mainly on the leg and the arm. The condition may be associated with a range of causes such as venous diseases, trauma, infection, joint disease and orthopaedic surgery. Oedema is caused by both lymphatic and chronic venous insufficiency, which leads to pooling of blood and fluid in the extremities. This results in swelling, mild redness and scaling of the skin, all of which can culminate in ulceration. Methods We present a method to model a wide variety of geometries of limbs affected by oedema and venous ulcers. The shape modelling is based on the PDE method where a set of boundary curves are extracted from 3D scan data and are utilised as boundary conditions to solve a PDE, which provides the geometry of an affected limb. For this work we utilise a mixture of fourth order and sixth order PDEs, the solutions of which enable us to obtain a good representative shape of the limb and associated ulcers in question. Results A series of examples are discussed demonstrating the capability of the method to produce good representative shapes of limbs by utilising a series of curves extracted from the scan data. In particular we show how the method could be used to model the shape of an arm and a leg with an associated ulcer. Conclusion We show how PDE based shape modelling techniques can be utilised to generate a variety of limb shapes and associated ulcers by means of a series of curves extracted from scan data. We also discuss how the method could be used to manipulate a generic shape of a limb and an associated wound so that the model could be fine-tuned for a particular patient.

  8. Prophylaxis against venous thromboembolism in orthopedic surgery

    Institute of Scientific and Technical Information of China (English)

    LIU Lin-tao; MA Bao-tong

    2006-01-01

    Venous thromboembolism ( VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability,and discomfort. They are frequent complications of various surgical procedures. The aging population and the survival of more severely injured patients may suggest an increasing risk of thromboembolism in the trauma patients. Expanded understanding of the population at risk challenges physicians to carefully examine risk factors for VTE to identify high-risk patients who can benefit from prophylaxis. An accurate knowledge of evidence-based risk factors is important in predicting and preventing postoperative DVT, and can be incorporated into a decision support system for appropriate thromboprophylaxis use.Standard use of DVT prophylaxis in a high-risk trauma population leads to a low incidence of DVT. The incidence of VTE is common in Asia. The evaluation includes laboratory tests, Doppler test and phlebography. Screening Doppler sonography should be performed for surveillance on all critically injured patients to identify DVT. D-Dimer is a useful marker to monitor prophylaxis in trauma surgery patients. The optimal time to start prophylaxis is between 2 hours before and 10 hours after surgery, but the risk of PE continues for several weeks. Thromboprophylaxis includes graduated compression stockings and anticoagulants for prophylaxis. Anticoagulants include Warfarin, which belongs to Vitamin K antagonists, unfractionated heparin,low molecular weight heparins, factor Xa indirect inhibitor Fondaparinux, and the oral Ⅱa inhibitor Melagatran and ximelagatran. Recombinant human soluble thrombomodulin is a new and highly effective antithrombotic agent. Prophylactic placement of vena caval filters in selected trauma patients may decrease the incidence of PE. The indications for prophylactic inferior vena cava filter insertion include prolonged immobilization with multiple injuries, closed head injury, pelvic

  9. Femoral venous reflux abolished by greater saphenous vein stripping.

    Science.gov (United States)

    Walsh, J C; Bergan, J J; Beeman, S; Comer, T P

    1994-11-01

    Preoperative venous duplex scanning has revealed unexpected deep venous incompetence in patients with apparently only varicose veins. Acting on the hypothesis that the deep vein reflux was secondary to deep vein dilation caused by reflux volume, the following was done. Between July 1990 and April 1993, 29 limbs in 21 patients (16 females) were examined by color-flow duplex imaging to determine valve closure by the method of van Bemmelen. Instrumentation included high-resolution ATL-9 venous interrogation using a pneumatic cuff deflation stimulus of reflux in the standing, nonweight-bearing limb. All limbs showed greater saphenous vein reflux. Twenty-nine showed superficial femoral vein reflux and of these three showed popliteal vein reflux. Duplex testing was performed by a certified vascular technologist whose interpretation was blinded as to the results of clinical examination and grading of the severity of venous insufficiency. Surgery was performed on an outpatient basis under general anesthesia using groin-to-knee removal of the greater saphenous vein by the vein inversion technique of Van Der Strict. Stab avulsion of varicose tributary veins was accomplished during the same period of anesthesia. In 27 of 29 limbs with preoperative femoral reflux, that reflux was abolished by greater saphenous stripping. In patients with popliteal reflux both femoral and popliteal reflux was abolished. Improvement of deep venous hemodynamics by ablation of superficial reflux supports the reflux circuit theory of venous overload. Furthermore, preoperative evaluation of venous hemodynamics by duplex scanning appears to provide useful pre- and postoperative information regarding venous insufficiency in individual patients. PMID:7865395

  10. Superficial venous thrombosis: disease progression and evolving treatment approaches

    OpenAIRE

    Litzendorf ME; Satiani B

    2011-01-01

    Maria E Litzendorf, Bhagwan SatianiHeart and Vascular Center and Division of Vascular Surgery, Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USAAbstract: Treatment of superficial venous thrombosis (SVT) has recently shifted as increasing evidence suggests a higher than initially recognized rate of recurrence as well as concomitant deep venous thrombosis. Traditional therapies aimed at symptom control and disruption of the saphenofemoral junction are being...

  11. DELAYED BILATERAL HYDROTHORAX AFTER CENTRAL VENOUS CATHERIZATION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Arpana

    2014-09-01

    Full Text Available : Central venous catheterization is a common procedure in anesthetic management of patients undergoing major surgery or care of critically ill patients. Delayed complication such as hydrothorax, hydromediastinum or cardiac tamponade is extremely rare with a few case reports. We report a case of bilateral hydrothorax due to migration of the tip of the central venous catheter from within the vein into the mediastinum following subclavian vein catheterization.

  12. Cortical venous thrombosis following exogenous androgen use for bodybuilding

    OpenAIRE

    Sveinsson, Olafur; Herrman, Lars

    2013-01-01

    There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic–clonic seizure. At admission, he was drowsy, not fully orientated, had sensory inattention, pronation drift and a positive extensor response, all on the left side. The pat...

  13. Venous obstruction in permanent pacemaker patients: an isotopic study

    International Nuclear Information System (INIS)

    Isotope venography was used to study the venous circulation proximal to the superior vena cava in two groups of pacemaker patients, one with a single endocavitary electrode and the other with multiple pacing catheters. A control group of patients without pacemakers was also studied. Numerous abnormalities were found, especially in the group with multiple electrodes. These findings suggest that venous obstruction is a common complication of endocardial pacing

  14. Venous obstruction in permanent pacemaker patients: an isotopic study

    Energy Technology Data Exchange (ETDEWEB)

    Pauletti, M.; Di Ricco, G.; Solfanelli, S.; Marini, C.; Contini, C.; Giuntini, C.

    1981-01-01

    Isotope venography was used to study the venous circulation proximal to the superior vena cava in two groups of pacemaker patients, one with a single endocavitary electrode and the other with multiple pacing catheters. A control group of patients without pacemakers was also studied. Numerous abnormalities were found, especially in the group with multiple electrodes. These findings suggest that venous obstruction is a common complication of endocardial pacing.

  15. Visualization of coronary venous anatomy by cardiovascular magnetic resonance

    OpenAIRE

    Crean Andrew; Plein Sven; Younger John F; Ball Stephen G; Greenwood John P

    2009-01-01

    Abstract Background Coronary venous imaging with whole-heart cardiovascular magnetic resonance (CMR) angiography has recently been described using developmental pulse sequences and intravascular contrast agents. However, the practical utility of coronary venous imaging will be for patients with heart failure in whom cardiac resynchronisation therapy (CRT) is being considered. As such complementary information on ventricular function and myocardial viability will be required. The aim of this s...

  16. Severe anemia causing cerebral venous sinus thrombosis in an infant

    OpenAIRE

    Sushil Beri; Arif Khan; Nahin Hussain; Jayaprakash Gosalakkal

    2012-01-01

    Iron deficiency anemia is a common pediatric problem affecting up to 25% children worldwide. It has been linked with cerebral venous sinus thrombosis in the literature. We describe a 9-month-old child who had severe iron deficiency anemia and developed acute venous sinus thrombosis associated with minor infection. Treatment with anticoagulation was partially successful with persistent thrombosis after 3 months. We reviewed the current literature highlighting the association of anemia as a ris...

  17. Venous gas embolism: An unusual complication of laparoscopic cholecystectomy

    OpenAIRE

    Wenham Tim; Graham Donald

    2009-01-01

    Venous gas embolism (VGE) is a rare but potentially lethal complication of many forms of surgery, especially posterior fossa neurosurgery where the incidence is reported to be up to 80% - it can also occur in laparoscopic surgery. It usually occurs early in the procedure during insufflation of the abdomen. Rapid entry or large volumes of gas entering the venous circulation initiate a predictable chain of pathophysiological events which may continue to cardiovascular collapse. Arterial ...

  18. Cardiovascular risk factors and risk of venous thromboembolism

    OpenAIRE

    Brækkan, Sigrid Kufaas

    2010-01-01

    Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common disease, with serious short- and long-term complications and a potential fatal outcome. Despite the knowledge of several inherited and acquired risk factors for VTE, still 30-50 % of the VTE events occur in the absence of obvious predisposing factors. Traditionally, arterial and venous thrombosis has been considered as separate disease entities with different pathology, epidemiology and treatments...

  19. Diet as prophylaxis and treatment for venous thromboembolism?

    OpenAIRE

    Cundiff David K; Agutter Paul S; Malone P; Pezzullo John C

    2010-01-01

    Abstract Background Both prophylaxis and treatment of venous thromboembolism (VTE: deep venous thrombosis (DVT) and pulmonary emboli (PE)) with anticoagulants are associated with significant risks of major and fatal hemorrhage. Anticoagulation treatment of VTE has been the standard of care in the USA since before 1962 when the U.S. Food and Drug Administration began requiring randomized controlled clinical trials (RCTs) showing efficacy, so efficacy trials were never required for FDA approval...

  20. Soft-tissue CT changes in pelvic venous thrombosis

    International Nuclear Information System (INIS)

    The computed tomographic (CT) changes in the soft tissues of the pelvis are presented in three patients with pelvic venous thrombosis. Pelvic venous thrombosis may lead to swelling of surrounding muscles and may present as a pelvic mass. This mass can simulate a tumor clinically, radiographically, and sonographically, but its origin and cause can be demonstrated by CT. Proper understanding of such changes may prevent an erroneous diagnosis of enlarged pelvic lymph nodes or an inflammatory or neoplastic mass

  1. Cerebral Venous Thrombosis after Ventriculoperitoneal Shunting: A Case Report

    OpenAIRE

    Matsubara, Teppei; AYUZAWA, Satoshi; AOKI, Tsukasa; Ikeda, Go; SHIIGAI, Masanari; Matsumura, Akira

    2013-01-01

    Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One pos...

  2. Chronic Bronchitis

    Science.gov (United States)

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It ... chest tightness. There are two main types of bronchitis: acute and chronic. Chronic bronchitis is one type ...

  3. Selective arterial and venous MR angiography of intracranial arteriovenous malformations

    International Nuclear Information System (INIS)

    This study evaluates the usefulness of MR angiography (MRA) in analysing cerebral arterial blood supply and venous drainage in patients with intracranial arteriovenous malformations (AVM). Selective MRA of the carotid, middle cerebral or vertebrobasilar territories was performed by means of presaturation of up to three of the brain-supplying arteries at the level of the middle or lower neck (angled presaturation slabs). Results obtained with selective, non-selective arterial, as well as venous MRA in 13 consecutive patients were compared with the findings at intraarterial angiography, the latter serving as the 'gold standard'. Sensitivity in identifying major feeding arteries was 100%. Determination of the absolute and relative AVM sizes at selective MRA corresponded with IAA. The mean difference was 17.6 and 3.9% respectively. Both display of superficial and deep venous drainage was provided by 2-dimensional venous MRA. The authors conclude that selective MRA of cerebral arteries as used here is a powerful non-invasive method to demonstrate blood supply by single feeding vessels in intracranial malformations. 2D venous MRA permits an accurate evaluation of the venous drainage pattern. (orig.)

  4. Portal-venous gas unrelated to mesenteric ischemia

    International Nuclear Information System (INIS)

    The aim of this study was to report on 8 patients with all different non-ischemic etiologies for portal-venous gas and to discuss this rare entity and its potentially misleading CT findings in context with a review of the literature. The CT examinations of eight patients who presented with intrahepatic portal-venous gas, unrelated to bowel ischemia or infarction, were reviewed and compared with their medical records with special emphasis on the pathogenesis and clinical impact of portal-venous gas caused by non-ischemic conditions. The etiologies for portal-venous gas included: abdominal trauma (n=1); large gastric cancer (n=1); prior gastroscopic biopsy (n=1); prior hemicolectomy (n=1); graft-vs-host reaction (n=1); large paracolic abscess (n=1); mesenteric recurrence of ovarian cancer superinfected with clostridium septicum (n=1); and sepsis with Pseudomonas aeruginosa (n=1). The clinical outcome of all patients was determined by their underlying disease and not negatively influenced by the presence of portal-venous gas. Although the presence of portal-venous gas usually raises the suspicion of bowel ischemia and/or intestinal necrosis, this CT finding may be related to a variety of non-ischemic etiologies and pathogeneses as well. The knowledge about these conditions may help to avoid misinterpretation of CT findings, inappropriate clinical uncertainty and unnecessary surgery in certain cases. (orig.)

  5. Aneurysms of the superficial venous system: classification and treatment

    Directory of Open Access Journals (Sweden)

    Ronald G. Bush

    2014-11-01

    Full Text Available Superficial venous aneurysms are rarely described and they may remain indolent or become the source for pulmonary emboli. A system of classification and treatment protocol according to size and location is proposed. Three hundred thirty patients were evaluated for symptomatic venous disease (C2-C6 over a 2-year period. A proposed designation for venous aneurysm is described. Patients fulfilling this criterion are described in reference to site of involvement, histologic findings, and method of treatment. Five percent of patients met the criteria for venous aneurysm. Nine aneurysms of the greater saphenous vein were identified. Three aneurysms were proximal to the subterminal valve and the rest were distal. Six aneurysms of the anterior accessory greater saphenous vein (AAGSV were identified. Three aneurysms of the AAGSV spontaneously thrombosed. Two patients presented with aneurysms of the small saphenous vein. Histology revealed thickened intima, smooth muscle and adventitia. Aneurysm designation relates to diameter of normal and contiguous vein. All superficial venous aneurysms in close proximity to the junction of the femoral or popliteal vein should be ligated. Classification of venous aneurysms should include the AAGSV, which may present with spontaneous thrombosis.

  6. Fish Intake and Venous Thromboembolism: A Systematic Literature Review.

    Science.gov (United States)

    Mattiuzzi, Camilla; Cervellin, Gianfranco; Franchini, Massimo; Lippi, Giuseppe

    2016-05-01

    Diet plays an important role in modulating the risk of arterial and venous thrombosis. Several lines of evidence attest that consumption of fish and its compounds, especially omega-3 fatty acids, may be effective to decrease the cardiovascular risk. Since the pathogenesis of arterial and venous thrombosis share some common aspects, we performed a systematic review of published clinical studies that investigated the association between fish intake and venous thrombosis. An electronic search was carried out in Medline, Scopus, and ISI Web of Science using the key words "fish" OR "seafood" AND "venous thromboembolism" OR "deep vein thrombosis" OR "pulmonary embolism", with no language or date restriction. Overall, 6 studies (5 prospective and 1 case-control) were finally identified. In only 1 small case-control study, a larger intake of total fish was found to be negatively associated with the risk of venous thromboembolism. No association was found in 4 large prospective studies, whereas a positive association was observed in the remaining. No substantial difference was also noticed between intake of fatty or lean fish. Taken together, the current epidemiological evidence does not support the existence of a significant effect of total fish consumption on the risk of venous thromboembolism. PMID:25962392

  7. Chronic gastritis

    OpenAIRE

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-01-01

    Abstract Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understand...

  8. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  9. Pulmonary Venous Obstruction in Cancer Patients

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    Chuang-Chi Liaw

    2015-01-01

    Full Text Available Background. We study the clinical significance and management of pulmonary venous obstruction in cancer patients. Methods. We conducted a prospective cohort study to characterize the syndrome that we term “pulmonary vein obstruction syndrome” (PVOS between January 2005 and March 2014. The criteria for inclusion were (1 episodes of shortness of breath; (2 chest X-ray showing abnormal pulmonary hilum shadow with or without presence of pulmonary edema and/or pleural effusion; (3 CT scan demonstrating pulmonary vein thrombosis/tumor with or without tumor around the vein. Results. Two hundred and twenty-two patients developed PVOS. Shortness of breath was the main symptom, which was aggravated by chemotherapy in 28 (13%, and medical/surgical procedures in 21 (9% and showed diurnal change in intensity in 32 (14%. Chest X-rays all revealed abnormal pulmonary hilum shadows and presence of pulmonary edema in 194 (87% and pleural effusion in 192 (86%. CT scans all showed pulmonary vein thrombosis/tumor (100% and surrounding the pulmonary veins by tumor lesions in 140 patients (63%. PVOS was treated with low molecular weight heparin in combination with dexamethasone, and 66% of patients got clinical/image improvement. Conclusion. Physicians should be alert to PVOS when shortness of breath occurs and chest X-ray reveals abnormal pulmonary hilum shadows.

  10. Presentation of Epilepsy in a Patient with Wilson's Disease and Developmental Venous Anomaly (Venous Angioma) in the Brain

    OpenAIRE

    Ammar Alobaidy; Faisal Alazri; Jacob, P. C.; Al-Kalbani, Jamila H.

    2012-01-01

    Intracranial developmental venous anomalies (DVAs), also called venous angiomas, and Wilson’s disease are both considered rare disorders with varying degrees of neurologic and systemic manifestations; yet the coexistence of the two disorders is considered extremely rare, bearing in mind the low prevalence of each disorder. Epilepsy is a recognised presentation in these disorders and will be the focus of discussion in our report of a 21-year-old male patient who, based on a clinical examinatio...

  11. The design, development, and evaluation of a prototypic, prosthetic venous valve

    Directory of Open Access Journals (Sweden)

    Rittgers Stanley E

    2008-09-01

    Full Text Available Abstract Background Chronic venous insufficiency is a serious disease for which there is no clearly successful surgical treatment. Availability of a proven prosthetic vein valve could provide such an option by reducing venous reflux while permitting normal antegrade flow. Methods A new prosthetic vein valve design has been developed which mimics the function of a natural valve by ensuring complete closure of the leaflets with minimal obstruction for antegrade flow. A 2:1 mock-up of the device was tested to evaluate its ability to prevent regurgitation and several key modifications were made. A subsequently re-designed 1:1 prototype was then built in 4 slightly different size configurations and then each tested under physiologic conditions of pulsatile flow in both supine and standing positions. Results Each of the configurations showed acceptable amounts of antegrade resistance and effective orifice area and showed low values of regurgitation and % reflux with two of the prototype configurations (flange lengths of 2.5 mm and 3.75 mm having corresponding values of 97%, 11 mL, and 36%, respectively. These values are particularly striking when compared to the corresponding regurgitation and % reflux values of 60 mL and 205%, respectively, when no device is present. Conclusion The results of this study show that this prototype vein valve design is capable of providing significant relief of reflux under realistic conditions without inducing any increase in antegrade flow resistance and warrants further testing with in vivo models.

  12. Angiographically proven cervical venous engorgement: a possible concurrent cause in the pathophysiology of Hirayama's myelopathy.

    Science.gov (United States)

    Ciceri, Elisa F; Chiapparini, Luisa; Erbetta, Alessandra; Longhi, Laura; Cicardi, Benedetta; Milani, Nicoletta; Solero, Carlo Lazzaro; Savoiardo, Mario

    2010-12-01

    The objective of this study is to discuss the possible role of cervical posterior epidural plexus engorgement during cervical flexion in the pathogenesis of Hirayama myelopathy. In Hirayama disease, MRI during neck flexion often shows that the posterior dura detaches from the posterior arches compressing the spinal cord. Autopsies demonstrated asymmetric changes in the anterior horns consistent with chronic ischemic damage, attributed to arterial insufficiency during flexion or to microcirculatory changes due to compression by the tight dura. In a 15-year-old patient with 5-year history of distal upper limbs weakness, MRI demonstrated marked venous engorgement of the posterior epidural plexus in cervical flexion, confirmed by angiography. Laminectomy from C3 to C6 with duraplasty was performed. At one-year follow-up, the clinical condition of the patient remained stable. In Hirayama myelopathy, compression of the spinal cord by the tight dura is probably the most important pathogenetic factor. However, venous congestion in flexion might play an additional role in determining spinal cord ischemic changes. PMID:20857161

  13. Pathophysiology of wound healing and alterations in venous leg ulcers-review.

    Science.gov (United States)

    Raffetto, Joseph D

    2016-03-01

    Venous leg ulcer (VLU) is one of the most common lower extremity ulcerated wound, and is a significant healthcare problem with implications that affect social, economic, and the well-being of a patient. VLU can have debilitating related problems which require weekly medical care and may take months to years to heal. The pathophysiology of VLU is complex, and healing is delayed in many patients due to a persistent inflammatory condition. Patient genetic and environmental factors predispose individuals to chronic venous diseases including VLU. Changes in shear stress affecting the glycocalyx are likely initiating events, leading to activation of adhesion molecules on endothelial cells, and leukocyte activation with attachment and migration into vein wall, microcirculation, and in the interstitial space. Multiple chemokines, cytokines, growth factors, proteases and matrix metalloproteinases are produced. The pathology of VLU involves an imbalance of inflammation, inflammatory modulators, oxidative stress, and proteinase activity. Understanding the cellular and biochemical events that lead to the progression of VLU is critical. With further understanding of inflammatory pathways and potential mechanisms, certain biomarkers could be revealed and studied as both involvement in the pathophysiology of VLU but also as therapeutic targets for VLU healing. PMID:26916770

  14. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    OpenAIRE

    Langer Astrid; Rogowski Wolf

    2009-01-01

    Abstract Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Metho...

  15. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Sumit; Ramakrishnaiah, Raghu H.; Hegde, Shilpa V.; Glasier, Charles M. [University of Arkansas for Medical Sciences, Pediatric Radiology, Little Rock, AR (United States)

    2016-01-15

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  16. Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings

    International Nuclear Information System (INIS)

    Posterior fossa dural venous sinus thrombus is a well-described complication of head trauma, especially when fracture crosses the dural sinus grooves or in association with epidural hemorrhage. We have found that post-traumatic posterior fossa epidural hematoma compressing a dural venous sinus can mimic dural venous thrombus. To discuss the CT and MRI findings of posterior fossa epidural hemorrhages simulating sinus thrombosis, to make radiologists aware of this important imaging pitfall. We describe radiologic findings in four children in whom a posterior fossa epidural hemorrhage mimicked dural venous sinus thrombus. Routine CT head and CT venography were obtained on Toshiba volume and helical CT scanners. MRI and MR venography were performed on a Philips scanner. In all cases there was medial displacement and compression of the posterior fossa dural venous sinuses without intraluminal thrombosis. The epidural hemorrhage was seen tracking along sinus grooves in the occipital bone, peeling the dura containing the sinuses from the calvarium and compressing the sinus, simulating thrombosis on axial CT views. Both venous sinus thrombosis and posterior fossa epidural hemorrhages in children are well-described complications of head trauma. Posterior fossa epidural hemorrhage can mimic a sinus thrombus by compressing and displacing the sinuses. It is important to recognize this pitfall because treatment of a suspected thrombus with anticoagulation can worsen epidural hemorrhage. (orig.)

  17. Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations.

    Science.gov (United States)

    Mitsuhashi, Yutaka; Hayasaki, Koji; Kawakami, Taichiro; Nagata, Takashi; Kaneshiro, Yuta; Umaba, Ryoko; Ohata, Kenji

    2016-06-15

    The cavernous sinus (CS) is one of the cranial dural venous sinuses. It differs from other dural sinuses due to its many afferent and efferent venous connections with adjacent structures. It is important to know well about its complex venous anatomy to conduct safe and effective endovascular interventions for the CS. Thus, we reviewed previous literatures concerning the morphological and functional venous anatomy and the embryology of the CS. The CS is a complex of venous channels from embryologically different origins. These venous channels have more or less retained their distinct original roles of venous drainage, even after alterations through the embryological developmental process, and can be categorized into three longitudinal venous axes based on their topological and functional features. Venous channels medial to the internal carotid artery "medial venous axis" carry venous drainage from the skull base, chondrocranium and the hypophysis, with no direct participation in cerebral drainage. Venous channels lateral to the cranial nerves "lateral venous axis" are exclusively for cerebral venous drainage. Venous channels between the internal carotid artery and cranial nerves "intermediate venous axis" contribute to all the venous drainage from adjacent structures, directly from the orbit and membranous skull, indirectly through medial and lateral venous axes from the chondrocranium, the hypophysis, and the brain. This concept of longitudinal venous axes in the CS may be useful during endovascular interventions for the CS considering our better understandings of its functions in venous drainage. PMID:27063146

  18. Melanoma cutáneo con metástasis gástrica. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Jordi Alonso Soto

    2012-11-01

    Full Text Available El melanoma es una neoplasia maligna producto de la transformación de los melanocitos. Las metástasis en el aparato digestivo pueden ocurrir en un 10 %. Se presenta el caso de un paciente de 70 años de edad, con antecedentes de hipertensión arterial, que llevaba tratamiento regular con enalapril, de ocupación marino mercante, con mucha exposición al sol. En el año 2009 se le diagnosticó un melanoma en piel para lo que recibió tratamiento combinado de cirugía y quimioterapia, se mantuvo estable con seguimiento en la consulta de oncología y dermatología. Acudió a consulta por presentar cuadros de epigastralgia con marcada acidez que no se aliviaba ante la administración de omeprazol con que se había automedicado el paciente. Se comprobó melanoma cutáneo con metástasis en estómago.

  19. Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

    Institute of Scientific and Technical Information of China (English)

    梁晖; 陈甦; 陈少芳

    2002-01-01

    Objective: to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen (FIB) and D-dimer (DD) in plasma of patients with cerebral thrombosis. Method: 73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases. The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment. Result: FIB content in plasma after treatment was lower than that before treatment in the control group (P<0.01) and more remarkable in the treatment group (P<0.001). There was an obvious difference in DD content before and after treatment in both groups. DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group (P<0.01 and P<0.05 respectively). Conclusion: Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis, raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

  20. Effect of the Principle of Activating Blood Circulation to Break Stasis on GMP-140 and D2 Dimer in Patients with Acute Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    WANG Ning

    2005-01-01

    Objective:To explore the clinical efficacy of the principle of activating blood circulation to break stasis (ABCBS) and its influence on platelet membranous protein particle (GMP-140) and D2 dimer (Ddimer) before and after treatment. Methods: Eighty-eight patients with blood stasis syndrome (BSS) of acute cerebral infarction (ACI) were randomly divided into two groups, both of which were treated with conventional treatment, i.e. with western medicine (WM), with Salvia injection added through intravenously dripping.One of the two groups was used as the control and the other group as the treated group who had ABCBS herbs orally taken in addition. The duration of treatment course for both groups was 3 weeks. Results: There were changes in both groups over clinical symptoms, nerve function deficit scoring and GMP-140, D-dimer, but the treated group showed significantly better than that of the control group, (P<0.05). Conclusion: ABCBS principle could serve as an important auxiliary treating method for BSS of ACI, as it can effectively alter the blood of ACI patients which was viscous, condense, coagulant and aggregating.

  1. Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis: Experience from Combination Therapy in Chinese Medicine.

    Science.gov (United States)

    Xiong, Xing-Jiang; Wang, Zhong; Wang, Jie

    2015-01-01

    Coronary heart disease (CHD) is one of the leading causes of death worldwide. Moreover, angina pectoris is one of the most important types of CHD. Therefore, prevention and effective treatment of angina pectoris is of utmost importance in both China and western countries. However, undesirable effects of antianginal therapy do influence treatment adherence to a certain extent. Therefore, it's not surprising that, complementary and alternative medicine (CAM), including Chinese medicine (CM), are widely welcomed among patients with CHD, hoping that it might complement western medicine. In our previous studies, blood stasis syndrome (BSS) (Xueyu Zheng) was the main syndrome (Zheng-hou) of angina pectoris. Currently, China Food and Drug Administration authoritatively recommended more than 200 Chinese patent medicines (CPMs) as complementary or adjunctive therapies for symptom management and enhancing quality of life along with mainstream care on angina pectoris management in mainland China. This paper reviewed 4 kinds of most frequently-used CPMs by promoting blood circulation and removing blood stasis in the treatment of angina pectoris. It aims to evaluate the current evidence of CPMs in combination therapy for angina pectoris. This review indicated that CPMs as adjunctive treatment to routine antianginal therapy play an active role in reducing the incidence of primary endpoint events, decreasing anginal attack rate, and improving electrocardiogram. Additionally, CPMs have been proven relatively safe. Further rigorously designed clinical trials should be conducted to confirm the results. PMID:25360837

  2. Functional status of the deep venous system after an episode of deep venous thrombosis.

    Science.gov (United States)

    van Bemmelen, P S; Bedford, G; Beach, K; Strandness, D E

    1990-09-01

    An episode of deep venous thrombosis is often followed by the opening of collaterals, fibrinolysis, recanalization and valvular dysfunction. The effect of these processes on the peak flow velocity in the superficial femoral and popliteal veins after simulated contraction of the calf muscles was tested in a group of normal subjects and three groups of patients who had deep venous thrombosis. There were 12 patients followed less than two years with no skin changes. The second group consisted of 12 patients followed for 8-15 years without ulceration. The third group of 12 patients had active or healed ulcers. The peak flow velocity in the superficial femoral and popliteal veins was assessed by rapidly inflating cuffs about the calf and ankle to 100 mmHg. The velocities generated by cuff compression were lower in patients than in normal subjects. This was particularly true in the superficial femoral vein. This change in velocity may be secondary to incomplete recanalization with resulting stenosis or valvular incompetence in the calf. PMID:2223542

  3. The incidence of venous thromboembolism and practice of deep venous thrombosis prophylaxis in hospitalized cirrhotic patients

    Directory of Open Access Journals (Sweden)

    Alqahtani Saad

    2011-01-01

    Full Text Available Abstract Background Cirrhotic patients are characterized by a decreased synthesis of coagulation and anticoagulation factors. The coagulopathy of cirrhotic patients is considered to be auto-anticoagulation. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE and examine the practice of deep venous thrombosis (DVT prophylaxis among hospitalized cirrhotic patients. Methods A retrospective cohort study was performed in a tertiary teaching hospital. We included all adult patients admitted to the hospital with a diagnosis of liver cirrhosis from January 1, 2009 to December 31, 2009. We grouped our cohort patients in two groups, cirrhotic patients without VTE and cirrhotic with VTE. Results Over one year, we included 226 cirrhotic patients, and the characteristics of both groups were similar regarding their clinical and laboratory parameters and their outcomes. Six patients (2.7% developed VTE, and all of the VTEs were DVT. Hepatitis C was the most common (51% underlying cause of liver cirrhosis, followed by hepatitis B (22%; 76% of the cirrhotic patients received neither pharmacological nor mechanical DVT prophylaxis. Conclusion Cirrhotic patients are at risk for developing VTE. The utilization of DVT prophylaxis was suboptimal.

  4. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

    International Nuclear Information System (INIS)

    Objective: To explore and evaluate the efficacy of intrasinus thrombolysis (IST) in patients with cerebral venous sinus thrombosis (CVST) during postpartum period. Methods: 11 patients during postpartum period with CVST who received IST during July 2007–November 2011 were included. Urokinase was infused into the sinuses via a microcatheter. Magnetic resonance venography (MRV) was performed to assess the recanalization of venous sinuses. Results: Before discharge, the intracranial pressure in 11 patients was under 200 mmH2O. MRV confirmed that venous sinus of 9 patients were smooth. The cortex venous and deep venous recovered to normal. Venous sinus of 2 patients recanalized partly, and cortex venous and deep venous had compensation. 9 patients had good outcome and 2 patients had only mild deficits. Conclusion: Intrasinus thrombolysis is safe and effective in patients with severe cerebral venous sinus thrombosis during postpartum period

  5. Local thrombolysis for patients of severe cerebral venous sinus thrombosis during puerperium

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Xin-bin, E-mail: gxb3906080@sina.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Fu, Zhenqiang, E-mail: fuzhenqiang1005@163.com [Department of Neurology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Song, Lai-jun, E-mail: laijunsong@sina.com [Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China); Guan, Sheng, E-mail: gsradio@126.com [Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052 (China)

    2013-01-15

    Objective: To explore and evaluate the efficacy of intrasinus thrombolysis (IST) in patients with cerebral venous sinus thrombosis (CVST) during postpartum period. Methods: 11 patients during postpartum period with CVST who received IST during July 2007–November 2011 were included. Urokinase was infused into the sinuses via a microcatheter. Magnetic resonance venography (MRV) was performed to assess the recanalization of venous sinuses. Results: Before discharge, the intracranial pressure in 11 patients was under 200 mmH{sub 2}O. MRV confirmed that venous sinus of 9 patients were smooth. The cortex venous and deep venous recovered to normal. Venous sinus of 2 patients recanalized partly, and cortex venous and deep venous had compensation. 9 patients had good outcome and 2 patients had only mild deficits. Conclusion: Intrasinus thrombolysis is safe and effective in patients with severe cerebral venous sinus thrombosis during postpartum period.

  6. The application of thrombectomy with hydrolyser catheter in the treatment of lower extremity deep venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical effectiveness of thrombectomy with hydrolyser catheter combined with catheter-directed thrombolysis in the treatment of chronic lower extremity deep venous thrombosis (LEDVT). Methods: 15 patients with thrombosis in left iliac veins (n = 2), left iliac and femoral veins (n = 8 ), left and right iliac and femoral veins (n = 5). Inferior vena cava filters (LVCF) were placed in all patients via the normal femoral veins. Antegrade puncture and catheterization was carried out through the femoral veins or popliteal veins in the thrombotic side. Thrombus aspiration with hydrolyser catheter combined with intravascular thrombolysis was accomplished. Results: The success rate of percutaneous catheterization was 100% (15/15). Total effective rate was 93% (14/15). No serious complications were observed. Conclusion: Thrombectomy with hydrolyser catheter combined with catheter-directed thrombolysis in the treatments of LEDVT is safe and effective

  7. Diagnosing and managing venous leg ulcers in patients in the community.

    Science.gov (United States)

    Day, Julie

    2015-12-01

    Venous leg ulcers (VLUs) are a chronic condition affecting between 0.1% and 0.3% of the population in the UK. Healing rates are variable and recurrence rates are high. The diagnosis, assessment, and management of this patient group is primarily carried out in the community. Assessment of this patient group requires skill and competence to ensure a correct diagnosis is made. When carrying out the assessment, it is important to consider the patient's past medical history, medication, and allergies, as well as to record the ankle brachial pressure index (ABPI), pain level, palpation of pulses, and ankle joint movement, among other aspects of the assessment. VLUs heal with compression therapy, and practitioners should be knowledgeable about the various compression systems available in order to offer patients the most suitable and informed choices. PMID:26639070

  8. Portal venous hemodynamics in cystic fibrosis: A criterion of hepatic involvement

    International Nuclear Information System (INIS)

    In 24 patients with cystic fibrosis (CF), mean age 11.6 years, the velocity, flow volume, and cross-sectional area of the portal vein were determined by duplex-US, and findings were compared with findings in 30 age-matched controls. Size and echogenicity of liver and spleen were assessed by real-time US. There was a significant difference between CF and normal mean values, including, in CF, a decrease in velocity (P <.003), an increase in cross-sectional area (P <.001), and an increase in flow volume (P <.05). Changes in portal venous hemodynamics correlated with increased liver echogenicity and spleen size, suggestive of chronic parenchymal liver disease. Duplex US is a valuable diagnostic tool in the assessment of hepatic involvement in CF

  9. Communicating hydrocephalus due to cerebral venous sinus thrombosis treated with ventriculoperitoneal shunt

    Directory of Open Access Journals (Sweden)

    Rahul T Chakor

    2012-01-01

    Full Text Available Cerebral venous sinus thrombosis (CVT is a rare cerebrovascular disease with variable presentation. CVT rarely causes hydrocephalus. Communicating hydrocephalus due to CVT is extremely rare. We describe a patient of CVT presenting with chronic headache and communicating hydrocephalus. The patient was successfully treated with ventriculoperitoneal (VP shunt. A 40 year old man presented with moderate to severe headache since six months and progressive visual loss since two months. Head Computed tomogram showed mild hydrocephalus without obstruction. Lumbar puncture (LP demonstrated elevated pressure but was otherwise normal. Magnetic resonance venogram showed extensive CVT. Repeated CSF drainage and thecoperitoneal shunt did not relieve the severe headache hence a VP shunt was placed. Post shunt headache subsided with resolution of hydrocephalus. CVT can present as communicating hydrocephalus. Gradual reduction of intra-ventricular pressure by repeated LPs followed by VP shunt can safely treat hydrocephalus due to CVT.

  10. Management of venous thromboembolism during pregnancy.

    Science.gov (United States)

    Ginsberg, J S; Bates, S M

    2003-07-01

    The incidence of venous thromboembolism (VTE) probably increases 2-4-fold in pregnancy and is higher after a caesarean section than after vaginal delivery. Management of VTE in pregnancy is challenging. Many diagnostic tests are less accurate in pregnant than in non-pregnant patients and some radiologic procedures expose the fetus to ionizing radiation, although this can be reduced by taking appropriate precautions. Compression ultrasonography (CUS) is the test of choice for deep vein thrombosis (DVT), whereas for PE, V/Q lung scan is the first-line test, followed by CUS if the results are non-diagnostic. Anticoagulants that have been evaluated for the prevention and treatment of VTE in pregnancy include heparin and heparin compounds, and coumarin derivatives. When determining the optimal treatment regimens, it is important to consider: (i) the safety of the drug for the fetus and mother; (ii) the efficacy of the regimen; and (iii) the dose regimens for acute and secondary treatment, and during delivery and postpartum. Heparins are safer than coumarins for the fetus, as they do not cross the placental barrier. Heparins, particularly unfractionated heparin (UFH) and low molecular weight heparin (LMWH) tend also to be safer for the mother than other compounds. Of the two, LMWHs, although more expensive, are associated with lower rates of bleeding complications, and heparin-induced thrombocytopenia and osteoporosis, than UFH, and should therefore be the treatment of choice in VTE during pregnancy. Patients with prior VTE or a hypercoagulable state have an increased risk of VTE during pregnancy. Depending on the presence of one or both of these factors, clinical surveillance, with anticoagulant treatment where necessary, is recommended. PMID:12871278

  11. Cerebral venous sinus thrombosis: a diagnostic challenge

    International Nuclear Information System (INIS)

    Cerebral venous sinus thrombosis (CVT) is a potentially serious but treatable disorder that has been underdiagnosed in the past. Delay in diagnosis and treatment of this disorder has resulted in the death of one of our patients. This paper reviews the local experience with CVT in order to identify factors that may allow diagnosis and appropriate treatment decisions to be made more readily in the future. A retrospective review of all cases of CVT diagnosed or treated at Auckland Hospital between 1990 and 1999. Twenty-five cases of CVT were identified. The number of cases diagnosed increased from less than one per year in 1990-94 to eight in 1999. Clinical signs at presentation included headache (96%), focal neurological deficits (60%), seizures (40%) and papilloedema (43%). Delayed diagnosis after admission to hospital occurred in two young women presenting with neurological symptoms during pregnancy or puerperium, in two cases in whom focal symptoms were not explained by negative computed tomography and in five cases presenting with intracerebral haemorrhage. Twenty patients received anticoagulant therapy and their condition remained stable or improved after treatment. The diagnosis of CVT should be considered in women with any neurological symptoms during pregnancy or puerperium and in all cases of unexplained intracerebral haemorrhage. CVT should also be considered in cases of recent onset and progressive headache, particularly when associated with focal neurological symptoms or signs, seizures or papilloedema. Magnetic resonance imaging with magnetic resonance venography is the investigation of choice. Anticoagulation with heparin remains the mainstay of treatment, even in the presence of intracerebral haemorrhage

  12. SP-05VENOUS THROMBOEMBOLISM AND GLIOBLASTOMA

    Science.gov (United States)

    Yust-Katz, Shlomit; Mandel, Jacob; Ying, Yuan; Wu, Jimin; Courtney, C.; Ladha, Harshad; Pawar, Tushar; Gilbert, Mark; Armstrong, Terri

    2014-01-01

    The risk of venous thromboembolism (VTE) is very high for patients with brain tumors; Glioblastoma (GB) specifically is one of the most at risk cancers. The aim of this study is to estimate the frequency and identify potential risk factors of GB patients developing VTE during adjuvant chemotherapy and to test if the Khorana scale accurately predicts the risk of VTE among this patient population. We retrospectively reviewed patients with GB treated at MD Anderson during the years 2005-2011. The target population of our study was patients who developed VTE after starting adjuvant chemotherapy. Patients were excluded if they did not start treatment with the established standard of care, had less than 6 months follow up or if they developed VTE before starting adjuvant treatment. The study sample included 440 patients. 64 (14.5%) of them developed VTE. The median time to develop VTE was 6.5 months. On multivariate analysis male sex, BMI≥ 35, KPS ≤80, history of VTE and steroid therapy were significantly associated with the development of VTE. We also found that in this patient sample, the Khorana scale was not a valid predictive model in GB patients due to very poor specificity. Of the 64 patients who developed a VTE, 36 were treated with anticoagulation, 2 with an IVC filter, and 21 with both. Complications secondary to anticoagulation were reported in 16% (n = 10) of patients. The complications included intracranial hemorrhage, bleeding to other organs and thrombocytopenia. VTE is very common in patients with GB. Currently, we are lacking a scale that accurately predicts the risk of VTE among GB patients. Predictive scales used for other cancers do not seem valid for GB due to the unique nature of the disease. Future studies are needed to create an accurate predictive model for VTE in GB patients.

  13. Treatment of pregnancy related venous thromboembolism

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    Mitić Gorana

    2009-01-01

    Full Text Available Introduction. Prevention and treatment of venous thromboembolism during pregnancy are complicated since the use of antithrombotic drugs carries a certain risk to the mother, the fetus or both. Coumarins cross the placental barrier and may be responsible for bleeding, teratogenicity and central nervous system abnormalities. The risk of embriopathy is particularly high between 6 and 12 weeks of gestation. Treatement. Heparin is the treatment of choice for thrombosis during pregnancy because it is entirely safe for the fetus, unlike oral anticoagulants. The frequency of heparin-induced thrombocytopenia and osteoporosis is significantly lower if LMWH is applied, so this heparin type is preferable to UFH during pregnancy. Treatment of women with VTE during pregnancy, especially those with thrombophilia, requires individualized dosing and duration of antithrombotic thrapy. Peripartal management. In order to avoid the peripartum anticoagulant heparin effect and possible bleeding, heparin should be discontinued prior to the delivery and reintroduced after the parturition. PROPHYLACTIC REGIMEn. Prophylactic antithrombotic regimen during subsequent pregnancies should also be individualized. The use of low molecular weight heparins is becoming more widespread. They have reliable pharmacokinetics, require less frequent injections than unfractionated heparin and carry a lower risk of treatment complications. LMW heparins are safe and effective and they are replacing UFH as the anticoagulant of choice during pregnancy. Both UFH and LMWH are not secreted into breast milk and can be safely given to nursing mothers. Warfarin does not induce an anticoagulant effect in the breast-fed infant, so it can be safely used in women who require postpartum anticoagulant therapy.

  14. The Current Role of Venous Sampling in the Localization of Endocrine Disease

    International Nuclear Information System (INIS)

    Endocrine venous sampling plays a specific role in the diagnosis of endocrine disorders. In this article, we cover inferior petrosal sinus sampling, selective parathyroid venous sampling, hepatic venous sampling with arterial stimulation, adrenal venous sampling, and ovarian venous sampling. We review their indications and the scientific evidence justifying these indications in the diagnosis and management of Cushing's syndrome, hyperparathyroidism, pancreatic endocrine tumors, Conn's syndrome, primary hyperaldosteronism, pheochromocytomas, and androgen-secreting ovarian tumors. For each sampling technique, we compare its diagnostic accuracy with that of other imaging techniques and, where possible, look at how it impacts patient management. Finally, we incorporate venous sampling into diagnostic algorithms used at our institution

  15. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

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    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  16. Venous interventions. Pt. 1. Techniques and lower torso thromboses; Venoese Interventionen. T. 1. Interventionstechniken und Thrombosen der Bein- und Beckenvenen

    Energy Technology Data Exchange (ETDEWEB)

    Kamper, L.; Altenburg, A.; Mansour, M.; Haage, P. [Universitaetsklinik Witten/Herdecke, Klinik fuer diagnostische und interventionelle Radiologie, Helios Klinikum Wuppertal, Wuppertal (Germany); Krueger, K. [Vivantes Humboldt-Klinikum, Institut fuer Radiologie und Interventionelle Therapie, Berlin (Germany); Reimer, P. [Akademisches Lehrkrankenhaus der Universitaet Freiburg, Radiologie Gefaesszentrum Karlsruhe, Klinikum Karlsruhe, Karlsruhe (Germany)

    2009-03-15

    Venous thrombosis is one of the most common vascular diseases. Without treatment, pulmonary embolism is a potentially life-threatening complication. Long-term complications are chronic venous insufficiency and post-thrombotic syndrome. Medical anticoagulation is currently the standard therapy, since it prevents appositional thrombus growth although it usually can not prevent the development of post-thrombotic syndrome. The structure of the thrombotic material often leads to partial recanalisation with residual stenosis. Early and sufficient systemic thrombolysis with adequate concentration may achieve disintegration of the thrombus and preservation of venous valve function. Supplementary to conservative therapy, local catheter thrombolysis is possible even in cases with contraindications for a systemic thrombolysis therapy. Additional interventional techniques reduce the required concentration of the thrombolytic. Venous stenosis can be treated by balloon angioplasty and stent implantation. This article reviews the different percutaneous treatment options as well as their application and usefulness in thrombosis of the lower torso. (orig.) [German] Venoese Thrombosen zaehlen zu den haeufigsten Gefaesserkrankungen. Unbehandelt koennen sie zu lebensbedrohlichen Lungenarterienembolien fuehren. Spaetfolgen sind chronisch venoese Insuffizienz und postthrombotisches Syndrom. Die medikamentoese Antikoagulation ist derzeit die Standardtherapie, sie verhindert in erster Linie ein appositionelles Thrombuswachstum, kann aber die Entstehung eines postthrombotischen Syndroms meist nicht verhindern. Durch die Thrombusorganisation kommt es haeufig zu einer partiellen Rekanalisation mit Residualstenosen und Klappenfunktionsstoerung. Die systemische Thrombolyse kann bei zeitnahem Einsatz und ausreichender Konzentration eine Thrombusaufloesung mit Klappenfunktionserhalt bewirken. Als Ergaenzung zur konventionellen Therapie ist die lokale Katheterthrombolyse auch bei

  17. Venous velocity increase with a pneumatic foot compression garment.

    Science.gov (United States)

    Ilgenfritz, F M; Meier, J R

    1994-11-01

    Intermittent compression garments have been widely accepted for prophylaxis of deep venous thrombosis. They have broad applicability in both elective and emergent situations. Development of a new type of garment that acts to compress the plantar plexus of the foot provides a potential method of prophylaxis for patients with contraindications to the traditional calf- or thigh-high garments. Evaluation of the ability of the foot compression garment demonstrates a statistically significant increase in peak femoral venous velocity (40.6 cm/sec) as compared with the resting state (25.9 cm/sec). This increase in femoral venous velocity is comparable to that seen with single-cell compression socks. The authors conclude that the recently introduced foot garment produces increases in peak femoral venous velocity similar to those produced by existing garments and that use of the foot compression garment may provide deep venous thrombosis prophylaxis in patients who previously have not been candidates for a compression garment. PMID:7978509

  18. Dorsalis pedis arterialized venous flap for hand and foot reconstruction

    Institute of Scientific and Technical Information of China (English)

    YU Guang; LEI Hong-yu; GUO Shuang; HUANG Jian-hua; YU Hao

    2012-01-01

    Objective:To report the results of repair of skin defects in the extremities with arterialized venous flap harvested from the lateral aspect of the dorsum of the foot.Methods:Six cases of skin and soft tissue defects over the foot and hands were resurfaced by free arterialized venous flaps,including five patients with skin defects of the hands,and one with defects at the dorsum of the foot.The flaps were harvested from the lateral aspect of the dorsum of the foot with the sizes ranging from 2 cm×5.5 cm to 6 cm×11 cm.Two veins at the proximal margin of the flap were retained,one of which was anastomosed to a recipient bed artery to provide arterial inflow and the other was anastomosed to a recipient bed vein for venous outflow.Results:All flaps demonstrated mild edema and survived completely.Blisters appeared on four flaps.Using this technique,we achieved good functional and cosmetic results in this series.Conclusions:Dorsalis pedis arterialized venous flap with rich vascular communications could enhance peripheral perfusion and decrease congestion of venous flaps,thereby improves reliability and utility for extremity reconstruction.

  19. Placement of an implantable central venous access device

    International Nuclear Information System (INIS)

    To evaluate the efficacy and safety of placement of a central venous catheter with infusion port into the superior vena cava. Central venous catheters with a infusion port were implanted in 21 patients (M:F=4:17, age range:15-63, mean age: 41) diagnosed as suffering from breast cancer (n=9), lymphoma (n=7), thymoma (n=2) rhabdomyosarcoma(n=2) and rectal cancer (n=1). The per(n=9), lymphoma(n=7), thymoma (n=2) rhabdomyosarcoma (n=2) and rectal cancer (n=1). The peripheral portion of the subclavian vein was punctured under fluoroscopic guidance during injection of contrast media at the site of the ipsilateral peripheral vein (20 cases) and under ultrasonographic guidance (1 case). 9.6F central venous catheters placed in the superior vena cava via the subclavian vein and the connected infusion ports were implanted in the subcutaneous pocket near the puncture site of the right anterosuperior chest wall. Radiologic placement under fluoroscopic guidance of a central venous catheter with a infusion port is easy, safe and useful for patients requiring long-term venous access. (author). 21 refs., 2 figs

  20. Accidental catheterization of epidural venous plexus: tomographic analysis

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    Mariano Paiva Souza

    2016-04-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Inadvertent venous catheterizations occur in approximately 9% of lumbar epidural anesthetic procedures with catheter placement and, if not promptly recognized, can result in fatal consequences. The objective of this report is to describe a case of accidental catheterization of epidural venous plexus and its recording by computed tomography with contrast injection through the catheter. CASE REPORT: A female patient in her sixties, physical status II (ASA, underwent conventional cholecystectomy under balanced general anesthesia and an epidural with catheter for postoperative analgesia. During surgery, there was clinical suspicion of accidental catheterization of epidural venous plexus because of blood backflow through the catheter, confirmed by the administration of a test dose through the catheter. After the surgery, a CT scan was obtained after contrast injection through the catheter. Contrast was observed all the way from the skin to the azygos vein, passing through anterior and posterior epidural venous plexuses and intervertebral vein. CONCLUSION: It is possible to identify the actual placement of the epidural catheter, as well as to register an accidental catheterization of the epidural venous plexus, using computed tomography with contrast injection through the epidural catheter.

  1. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

    Science.gov (United States)

    Faraji, Fardin; Didgar, Farshid; Talaie-Zanjani, Afsoon; Mohammadbeigi, Abolfazl

    2013-01-01

    Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient's history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control. PMID:24250168

  2. Air pollution and venous thrombosis: a meta-analysis

    Science.gov (United States)

    Tang, Liang; Wang, Qing-Yun; Cheng, Zhi-Peng; Hu, Bei; Liu, Jing-Di; Hu, Yu

    2016-01-01

    Exposure to air pollution has been linked to cardiovascular and respiratory disorders. However, the effect of air pollution on venous thrombotic disorders is uncertain. We performed a meta-analysis to assess the association between air pollution and venous thrombosis. PubMed, Embase, EBM Reviews, Healthstar, Global Health, Nursing Database, and Web of Science were searched for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matters) and venous thrombosis. Using a random-effects model, overall risk estimates were derived for each increment of 10 μg/m3 of pollutant concentration. Of the 485 in-depth reviewed studies, 8 citations, involving approximately 700,000 events, fulfilled the inclusion criteria. All the main air pollutants analyzed were not associated with an increased risk of venous thrombosis (OR = 1.005, 95% CI = 0.998–1.012 for PM2.5; OR = 0.995, 95% CI = 0.984–1.007 for PM10; OR = 1.006, 95% CI = 0.994–1.019 for NO2). Based on exposure period and thrombosis location, additional subgroup analyses provided results comparable with those of the overall analyses. There was no evidence of publication bias. Therefore, this meta analysis does not suggest the possible role of air pollution as risk factor for venous thrombosis in general population. PMID:27600652

  3. Uncontrolled seizures resulting from cerebral venous sinus thrombosis complicating neurobrucellosis

    Directory of Open Access Journals (Sweden)

    Fardin Faraji

    2013-01-01

    Full Text Available Cerebral venous sinus thrombosis is a rare form of stroke caused by thrombosis in venous sinuses of the brain. In this study, we reported on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure despite being treated with anti-epileptic drugs at high doses. The case was a 33-year-old woman with a history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month. She was febrile and a brain CT scan indicated hemorrhagic focus in the left posterior parietal and the temporal lobe. Magnetic resonance imaging and magnetic resonance venography also proved venous sinus thrombosis in the left transverse sinus. Besides [In addition], a laboratory assessment confirmed brucellosis. Following the treatment with anti-coagulant, anti-brucellosis, and anti-epileptic agents, the patient was discharged in good condition with medical orders. Clinical suspicion and accurate evaluation of a patient′s history is the most important clue in diagnosis and treatment of brucellosis and cerebral venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

  4. Air pollution and venous thrombosis: a meta-analysis.

    Science.gov (United States)

    Tang, Liang; Wang, Qing-Yun; Cheng, Zhi-Peng; Hu, Bei; Liu, Jing-Di; Hu, Yu

    2016-01-01

    Exposure to air pollution has been linked to cardiovascular and respiratory disorders. However, the effect of air pollution on venous thrombotic disorders is uncertain. We performed a meta-analysis to assess the association between air pollution and venous thrombosis. PubMed, Embase, EBM Reviews, Healthstar, Global Health, Nursing Database, and Web of Science were searched for citations on air pollutants (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone, and particulate matters) and venous thrombosis. Using a random-effects model, overall risk estimates were derived for each increment of 10 μg/m(3) of pollutant concentration. Of the 485 in-depth reviewed studies, 8 citations, involving approximately 700,000 events, fulfilled the inclusion criteria. All the main air pollutants analyzed were not associated with an increased risk of venous thrombosis (OR = 1.005, 95% CI = 0.998-1.012 for PM2.5; OR = 0.995, 95% CI = 0.984-1.007 for PM10; OR = 1.006, 95% CI = 0.994-1.019 for NO2). Based on exposure period and thrombosis location, additional subgroup analyses provided results comparable with those of the overall analyses. There was no evidence of publication bias. Therefore, this meta analysis does not suggest the possible role of air pollution as risk factor for venous thrombosis in general population. PMID:27600652

  5. Effects of low-frequency ultrasound on microcirculation in venous leg ulcers

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    Uwe Wollina

    2011-01-01

    Full Text Available Background: Therapeutic low-frequency ultrasound (US has been used for many years to improve wound healing in chronic wounds like venous leg ulcers. No human data are available for the possible effects of single US applications on microcirculation and their frequency-dependency. Aims: To investigated the role of therapeutic low-frequency US on microcirculation of venous leg ulcers in vivo. Patients and Methods: This is a pilot study on an inpatient basis. We use a newly developed low-frequency continuous-wave US-equipment composed of a US transducer based on piezo-fiber composites that allow the change of frequency. In this study, we apply US of 34 kHz, 53.5 kHz, and 75 kHz respectively. Twelve patients with chronic venous leg ulcers are analyzed. As an adjunct to good ulcer care, therapeutic US is applied, non-contacting, once a day, in a subaqual position for 10 minutes. Microcirculation is assessed in the ulcers adjacent to skin before US-therapy, immediately after the treatment and 30 minutes later. We use a micro-light guide spectrophotometer (O2C, LEA Medizintechnik GmbH, Gieίen, Germany for calculation of blood flow velocity, hemoglobin oxygen saturation (SCO 2 and relative hemoglobin concentration (rHb in 2 and 8 mm depth. Contact-free remission spectroscopy (SkinREM3, Color Control Chemnitz GmbH, Chemnitz, Germany allows contact free measurements in the VIS-NIR range of the spectrum (400 ± 1600 nm. Results: It is seen that therapeutic US is well tolerated. One patient dropped out from a treatment series since he developed erysipelas responding to standard antibiotic. Effects were seen at 34 kHz only. The SO 2 values increased after single US application. The values for rHb were higher in the superficial layer of the wound bed (depth 2 mm compared to deeper parts (8 mm depth. US treatment did not result in significant changes of rHb and blood cell velocity. The data obtained by remission spectroscopy disclose an increase of oxygenized

  6. Chronic migraine.

    Science.gov (United States)

    Schwedt, Todd J

    2014-01-01

    Chronic migraine is a disabling neurologic condition that affects 2% of the general population. Patients with chronic migraine have headaches on at least 15 days a month, with at least eight days a month on which their headaches and associated symptoms meet diagnostic criteria for migraine. Chronic migraine places an enormous burden on patients owing to frequent headaches; hypersensitivity to visual, auditory, and olfactory stimuli; nausea; and vomiting. It also affects society through direct and indirect medical costs. Chronic migraine typically develops after a slow increase in headache frequency over months to years. Several factors are associated with an increased risk of transforming to chronic migraine. The diagnosis requires a carefully performed patient interview and neurologic examination, sometimes combined with additional diagnostic tests, to differentiate chronic migraine from secondary headache disorders and other primary chronic headaches of long duration. Treatment takes a multifaceted approach that may include risk factor modification, avoidance of migraine triggers, drug and non-drug based prophylaxis, and abortive migraine treatment, the frequency of which is limited to avoid drug overuse. This article provides an overview of current knowledge regarding chronic migraine, including epidemiology, risk factors for its development, pathophysiology, diagnosis, management, and guidelines. The future of chronic migraine treatment and research is also discussed. PMID:24662044

  7. Correlation between obesity and the development of blood stasis syndrome%肥胖与血瘀证形成的相关性

    Institute of Scientific and Technical Information of China (English)

    陈贵海; 孙建; 陈利国

    2005-01-01

    BACKGROUND: Vascular complications usually occur in diseases related to obesity such as primary hypertension or diabetes. Treating obesity with the method of promoting blood circulation to remove blood stasis gains a curative effect, so we presume that obesity may be correlated to blood stasis syndrome.OBJECTIVE: Analyzing the relationship between leptin(Lep) and insulinmetabolism of sugar and fat,endothelin(ET),blood pressure,body mass index(BMI), etc. Comparison of the differences in Lep and BMI between the blood stasis syndrome group and the non-blood stasis syndrome group was conducted to explore the correlation between obesity and the blood stasis syndrome.DESIGN: An observatory and controlled study based on patients with hypertension or diabetes.SETTING: Wards of the department of dardiovascular dedicine and the department of dndocrinology of a university of traditional Chinese medicine.PARTICIPANTS: All the patients in the present study were hospitalized at the Department of Internal Medicine of the Second Affiliated Hospital(Jinan City, Shangdong Province) of Shandong University of Traditional Chinese Medicine from September 2000 to January 2001.Among them, 126 cases with hypertension were at the Department of Cardiovascular Medicine, and 133 cases with type 2 diabetes were at the Department of Endocrinology. Inclusion criteria: ① The diagnosis of diabetes followed the diagnostic criteria for diabetes that was formulated by the WHO in 1980; ② The diagnosis of hypertension followed the diagnostic criteria in"China' s Guidebook for Hypertension Prevention and Treatment." The patients were aged between 45-76 years. Exclusion criteria: ① Secondary hypertension,diabetics; ②Complicated with severe diseases; ③ Complicated with severe disfunction of the heart,lung,liver, kidney or severe primary diseases in hematopoietic system; ④ Patients with mental disorder or pregnant women or in the state of lactation; ⑤ Patients aged 76 years old; ⑥ Patients

  8. Arterio-venous shunts or low oxygen utilization?

    Science.gov (United States)

    Rozin, Alexander P

    2010-02-01

    An idea of arteriovenous shunts (AVS) was proposed for explanation of dynamic regulation of oxygenation and venous hyperoxia. A formula enabling calculation of AVS and real CO2 production has recently been derived by comparing data of arterial and venous blood gases. Regarding venous hyperoxia, there is a need to differentiate capillary to tissue transport defect (low oxygen utilisation-LOU) from AVS, which may exist simultaneously. The AVS may be associated with normal or relatively high oxygen utilization from the capillary vessels and increased CO2 production. AVS is proposed to carry protective and 'stealing' properties including renal, cardiac, and pulmonary hemodynamic. Calculations of the AVS may be important for dynamic assessment of vascular and metabolic status and in emergency medicine. PMID:20026514

  9. The value of interventional therapy in acute deep venous thrombosis

    International Nuclear Information System (INIS)

    Objective: To discuss the clinical application in the treatment of acute deep venous thrombosis by the intervention from Share vein little cutting edges. Methods: To treat 8 patients who are with acute deep venous thrombosis by using Share vein little cutting edges enter road comprehensive intervene treatment, to press and dissolve the thrombus. Among the 8 cases, put the bracket of hip total vein in 3 cases. The others put Next cavity vein strain permanently. Result: The success rate is 100%. After the treatment, the thrombus and swelling of the crura had gone, basically the patients could get back to a normal activity. Conclusion: It is quite complicated and dangerous in the treatment of acute deep venous thrombosis by the interposition from Share vein little cutting edges. But the curative effect is remarkable and it could dissolve the thrombus completely. (authors)

  10. Bilateral Emphysematous Pyelonephritis with Hepatic Portal Venous Gas: Case Report.

    Science.gov (United States)

    Cheng, Mao Li; Nording, Hasnizal; Lim, Chen Hong

    2015-01-01

    Emphysematous pyelonephritis is a rare life-threatening condition caused by a severe acute necrotising infection of the renal parenchyma and its perinephric tissues, and it is commonly seen in diabetic patients. There is a rare association between emphysematous pyelonephritis and hepatic portal venous gas. Hepatic portal venous gas is an uncommon radiological finding, which implies a significant underlying abdominal disease. The management of emphysematous pyelonephritis has evolved from prompt nephrectomy to medical therapy. In the present report, we present a case of a diabetic woman diagnosed with bilateral emphysematous pyelonephritis with hepatic portal venous gas that was successfully managed medically despite the presence of poor prognostic factors, such as acute renal failure and thrombocytopenia. PMID:26715900

  11. Cerebral venous thrombosis after ventriculoperitoneal shunting: a case report.

    Science.gov (United States)

    Matsubara, Teppei; Ayuzawa, Satoshi; Aoki, Tsukasa; Ikeda, Go; Shiigai, Masanari; Matsumura, Akira

    2014-01-01

    Ventriculoperitoneal shunting (VPS) is a simple procedure, but there are several potential complications. We describe the first reported case of cerebral venous thrombosis (CVT) after VPS. A 69-year-old man suffering from normal pressure hydrocephalus underwent left VPS. Two months later he developed CVT and cerebral venous hemorrhage in the left frontal lobe. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed the thrombus formation just adjacent to the shunt tube. One possible cause is compression of the cortical vein after brain shift and/or tension of the cortical vein due to intracranial hypotension. A protein C deficiency was also detected. Surgeons should be aware that cerebral venous thrombosis can occur after VPS. PMID:24257484

  12. Assistance protocol for venous ulcers patients: validation of contents

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    Daniele Vieira Dantas

    2013-07-01

    Full Text Available Venous ulcers require complex treatment and are responsible for significant morbidity and mortality rates. This study aims at identifying aspects validated by the jury for the preparation of an assistance protocol for venous ulcer sufferers. It is a descriptive and quantitative research, with 39 professionals (30 nurses, 7 doctors and two physiotherapists, held at the Onofre Lopes University Hospital, between April and July/2010. Data collection began through a questionnaire checklist. Analysis was performed through Statistical Package for Social Science 15.0, assessing compliance with guidelines. Results were the compositional aspects of the protocol: assessment of patient and lesion history/documentation, wound care/perilesional skin, dressing suggestion, use of antibiotics and pain treatment, surgical treatment/medication, improving venous return and relapse prevention, patient referral, professional training and referral/counter-referral. It was concluded that to compose the protocol, aspects related to diagnosis, treatment and injury prevention must be considered.

  13. Cortical venous thrombosis following exogenous androgen use for bodybuilding.

    Science.gov (United States)

    Sveinsson, Olafur; Herrman, Lars

    2013-01-01

    There are only a few reports of patients developing cerebral venous sinus thrombosis (CVST) after androgen therapy. We present a young man who developed cortical venous thrombosis after using androgens to increase muscle mass. He was hospitalised for parasthesia and dyspraxia in the left hand followed by a generalised tonic-clonic seizure. At admission, he was drowsy, not fully orientated, had sensory inattention, pronation drift and a positive extensor response, all on the left side. The patient had been using anabolic steroids (dainabol 20 mg/day) for the last month for bodybuilding. CT angiography showed a right cortical venous thrombosis. Anticoagulation therapy was started with intravenous heparin for 11 days and oral anticoagulation (warfarin) thereafter. A control CT angiography 4 months later showed resolution of the thrombosis. He recovered fully. PMID:23389726

  14. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies.

    Science.gov (United States)

    Byju, N; Jose, James; Saifudheen, K; Gafoor, V Abdul; Jithendranath, P

    2012-10-01

    Cerebral venous thrombosis (CVT) is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9(th), 10(th), and 12(th) cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment. PMID:23559730

  15. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies

    Directory of Open Access Journals (Sweden)

    N Byju

    2012-01-01

    Full Text Available Cerebral venous thrombosis (CVT is a well-recognized entity, but its clinical presentation is varied and often mimics many neurological disorders, making it a diagnostic challenge. Cerebral venous thrombosis has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, idiopathic intracranial hypertension, and stroke. Cerebral venous thrombosis presenting as multiple lower cranial nerve palsies, are rarely reported. We describe a pregnant lady who presented with sensorineural deafness of the right ear and paralysis of the 9 th , 10 th , and 12 th cranial nerves on the right side. She was diagnosed to have thrombosis of the right transverse sinus and sigmoid sinus with extension to the jugular vein and confluence of sinuses. She improved with anticoagulant treatment.

  16. Instantaneous venous oxygenation estimation using the Photoplethysmograph (PPG) waveform

    Energy Technology Data Exchange (ETDEWEB)

    Shafqat, K; Kyriacou, P A [School of Engineering and Mathematical Sciences, City University London, London (United Kingdom); Pal, S K [St Andrew' s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford (United Kingdom); Langford, R M, E-mail: k.shafqat@city.ac.uk [St. Bartholomew' s Hospital, Bart' s and The London NHS Trust, London (United Kingdom)

    2011-08-17

    In this study oesophageal photoplethysmograph data from eight patients under positive pressure ventilation were analysed in order to test the hypothesis that the modulations created by the ventilation in the AC Photoplethysmograph (PPG) signal could be used to estimate venous oxygen saturation. In order to estimate the instantaneous arterial and venous oxygen saturation Smoothed-pseudo Wigner-Ville Distribution (SPWVD) was utilised. The result from this study showed that there was no significant different in the conventional (time domain) arterial saturation and the instantaneous arterial saturation. However, the instantaneous venous oxygen saturation estimated with the ventilator modulation were significantly lower then the conventional arterial saturation (P = 0.008) and also from the instantaneous arterial saturation (P = 0.008).

  17. A Rare Case of Jejunal Arterio-Venous Fistula: Treatment with Superselective Catheter Embolization with a Tracker-18 Catheter and Microcoils

    International Nuclear Information System (INIS)

    Arterio-venous fistulas may develop spontaneously, following trauma or infection, or be iatrogenic in nature. We present a rare case of a jejunal arterio- venous fistula in a 35-year-old man with a history of pancreatic head resection that had been performed two years previously because of chronic pancreatitis. The patient was admitted with acute upper abdominal pain, vomiting and an abdominal machinery-type bruit. The diagnosis of a jejunal arterio-venous fistula was established by MR imaging. Transfemoral angiography was performed to assess the possibility of catheter embolization. The angiographic study revealed a small aneurysm of the third jejunal artery, abnormal early filling of dilated jejunal veins and marked filling of the slightly dilated portal vein (13-14 mm). We considered the presence of segmental portal hypertension. The patient was treated with coil embolization in the same angiographic session. This case report demonstrates the importance of auscultation of the abdomen in the initial clinical examination. MR imaging and color Doppler ultrasound are excellent noninvasive tools in establishing the diagnosis. The role of interventional radiological techniques in the treatment of early portal hypertension secondary to jejunal arterio-venous fistula is discussed at a time when this condition is still asymptomatic. A review of the current literature is included

  18. Effects of Blood-Activating and Stasis-Removing Drugs Combined with VEGF Gene Transfer on Angiogenesis in Ischemic Necrosis of the Femoral Head

    Institute of Scientific and Technical Information of China (English)

    LI Jun-hui; WU Ya-ling; YE Jian-hong; NING Ya-gong; YU Hai-ying; PENG Zhong-jie; LUAN Xiao-wen

    2009-01-01

    Objective:To observe the promoting effects of blood-activating and stasis-removing Chinese drugs combined with vascular endothelial growth factor (VEGF) gene transfer on angiogenesis in ischemic necrosis of the femoral head.Methods:Forty Japanese giant-ear rabbits were randomly divided into a control group, a model group, a Chinese drug group, a gene group, and a combined group.After 8 weeks of treatment, the rate of VEGF positive cell expression in the synovium of the femoral head was measured using the immunohistochemical method, and the number of blood vessels in the femoral head was measured by digital subtraction angiography.Results:The rate of VEGF positive cell expression in the model group was significantly lower than that in the Chinese drug group (P<0.05) and very significantly lower than those in other groups (P<0.01);but in the combined group it was significantly higher than in the Chinese drug group (P<0.05).The differences in the number of blood vessels in area A between the model group and other groups were not statistically significant.However, in area B, the number of blood vessels significantly increased in the control group, the gene group and the combined group as compared with the model group (P<0.05), and in the combined group the number of blood vessels was significantly more than in the gene group (P<0.05);but in the Chinese drug group it was not significantly different than the model group P>0.05).Conelusion:Either the blood-activating and stasis-removing Chinese drugs or VEGF gene transfer can promote the angiogenesis and building of collateral circulation for femoral head ischemic necrosis, and the combined therapy with Chinese drugs or VEGF gene transfer may show a better therapeutic effect.The present study provides an experimental basis for clinical application of the combined therapy with the blood-activating and stasis-removing Chinese drugs and VEGF gene transfer.

  19. Mercury levels in cord blood and meconium of healthy newborns and venous blood of their mothers: Clinical, prospective cohort study

    International Nuclear Information System (INIS)

    Objectives: The purpose of this study is to investigate the chronic mercury intoxication in pregnant women and newborns living in Istanbul, Turkey. Methods: The research was carried out as a prospective with 143 pregnant women and their newborns. Venous blood from the mother, cord blood from the neonate, and meconium were collected for mercury analysis. Frequency of fish and vegetable-eating and the number of teeth filled were investigated. Analyses were made in cold vapor Atomic Absorption Spectrophotometer (AAS, μg/L). Results: Mercury levels were 0.38 ± 0.5 μg/L (0-2.34) in venous blood of pregnant women, 0.50 ± 0.64 μg/L (0-2.36) in umbilical cord blood and 9.45 ± 13.8 μg/g (0-66.5) in meconium. Maternal blood mercury level was lower than the known toxic limit for humans (EPA, 5 μg/L). Mercury levels of the maternal venous blood were significantly correlated with umbilical cord blood. The primary risk factors affecting mercury levels were eating fishmeals more than twice a week and having filled teeth more than five. The fact that the mother had a regular vegetable diet everyday reduced the mercury levels. Increased levels of mercury in the mother and umbilical cord blood could lead to retarded newborns' weight and height. Conclusion: Pregnant women living in Istanbul may be not under the risk of chronic mercury intoxication. Fish consumption more than twice per week and tooth-filling of mother more than five may increase mercury level. On the contrary, regular diet rich in vegetable decreases the mercury level

  20. Deep venous thrombosis and atypical antipsychotics: three cases report

    Directory of Open Access Journals (Sweden)

    Sheikhmoonesi Fatemeh

    2012-10-01

    Full Text Available Abstract Background Deep venous Thrombosis is a serious, possible life threatening event which is often ignored in psychiatric Settings. Purpose In this paper three cases of deep venous Thrombosis (DVT following the use of olanzapine and risperidone are presented. Methods The data of Three patients was collected from hospital records. Results The patients were in good general physical health and had no personal or familial history of DVT. The patients were not overweight (BMI  Conclusion Risk of DVT exists in patients under treatment with atypical antipsychotics in spite of no pre existing risk factor.

  1. Chemoprophylaxis for Venous Thromboembolism Prevention: Concerns Regarding Efficacy and Ethics

    Directory of Open Access Journals (Sweden)

    Eric Swanson, MD

    2013-06-01

    Full Text Available Summary: Chemoprophylaxis has been recommended for plastic surgery patients judged to be at increased risk for venous thromboembolism. Several investigators have encountered this complication in patients despite anticoagulation therapy. An increased rate of complications related to postoperative bleeding has been reported. This article examines the efficacy and safety of this intervention, along with ethical considerations, in an attempt to determine whether any benefits of chemoprophylaxis justify the additional risks. The statistical methods and conclusion of the Venous Thromboembolism Prevention Study are challenged. Other preventative measures that do not cause negative side effects are discussed as safer alternatives.

  2. Central Venous Disease in Hemodialysis Patients: An Update

    Energy Technology Data Exchange (ETDEWEB)

    Modabber, Milad, E-mail: mmodabber@gmail.com [McMaster University, Michael G. DeGroote School of Medicine (Canada); Kundu, Sanjoy [Scarborough Hospital and Scarborough Vascular Ultrasound, The Vein Institute of Toronto (Canada)

    2013-08-01

    Central venous occlusive disease (CVD) is a common concern among the hemodialysis patient population, with the potential to cause significant morbidity. Endovascular management of CVD, comprising percutaneous balloon angioplasty and bare-metal stenting, has been established as a safe alternative to open surgical treatment. However, these available treatments have poor long-term patency, requiring close surveillance and multiple repeat interventions. Recently, covered stents have been proposed and their efficacy assessed for the treatment of recalcitrant central venous stenosis and obstruction. Moreover, newly proposed algorithms for the surgical management of CVD warrant consideration. Here, we seek to provide an updated review of the current literature on the various treatment modalities for CVD.

  3. Central Venous Disease in Hemodialysis Patients: An Update

    International Nuclear Information System (INIS)

    Central venous occlusive disease (CVD) is a common concern among the hemodialysis patient population, with the potential to cause significant morbidity. Endovascular management of CVD, comprising percutaneous balloon angioplasty and bare-metal stenting, has been established as a safe alternative to open surgical treatment. However, these available treatments have poor long-term patency, requiring close surveillance and multiple repeat interventions. Recently, covered stents have been proposed and their efficacy assessed for the treatment of recalcitrant central venous stenosis and obstruction. Moreover, newly proposed algorithms for the surgical management of CVD warrant consideration. Here, we seek to provide an updated review of the current literature on the various treatment modalities for CVD

  4. Severe anemia causing cerebral venous sinus thrombosis in an infant

    Directory of Open Access Journals (Sweden)

    Sushil Beri

    2012-01-01

    Full Text Available Iron deficiency anemia is a common pediatric problem affecting up to 25% children worldwide. It has been linked with cerebral venous sinus thrombosis in the literature. We describe a 9-month-old child who had severe iron deficiency anemia and developed acute venous sinus thrombosis associated with minor infection. Treatment with anticoagulation was partially successful with persistent thrombosis after 3 months. We reviewed the current literature highlighting the association of anemia as a risk factor for development of stroke in children.

  5. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  6. Management of catheter-associated upper extremity deep venous thrombosis.

    Science.gov (United States)

    Crawford, Jeffrey D; Liem, Timothy K; Moneta, Gregory L

    2016-07-01

    Central venous catheters or peripherally inserted central catheters are major risk factors for upper extremity deep venous thrombosis (UEDVT). The body and quality of literature evaluating catheter-associated (CA) UEDVT have increased, yet strong evidence on screening, diagnosis, prevention, and optimal treatment is limited. We herein review the current evidence of CA UEDVT that can be applied clinically. Principally, we review the anatomy and definition of CA UEDVT, identification of risk factors, utility of duplex ultrasound as the preferred diagnostic modality, preventive strategies, and an algorithm for management of CA UEDVT. PMID:27318061

  7. Hepatic portal venous gas in a critically ill patient.

    Science.gov (United States)

    Venkatesh, B; Tesar, P

    1998-10-01

    A case of hepatic portal venous gas following intestinal ileus in a critically ill patient in the intensive care unit, who went on to have a successful outcome, is described. Although hepatic portal venous gas (HPVG) is usually associated with an abdominal catastrophe and portends a poor clinical outcome, there are a number of benign causes of HPVG. The pathophysiological processes such as gut bacterial translocation and altered intestinal permeability that may occur as a paraphenomenon in the setting of HPVG are discussed. PMID:9807615

  8. Epidemiological study of venous thromboembolism in a big Danish cohort

    DEFF Research Database (Denmark)

    Severinsen, Marianne Tang; Kristensen, Søren Risom; Overvad, Kim;

    Introduction: Epidemiological data on venous thromboembolism (VT), i.e. pulmonary emboli (PE) and deep venous thrombosis (DVT) are sparse. We have examined VT-diagnoses registered in a big Danish Cohort study.  Methods: All first-time VT diagnoses in The Danish National Patient Register were...... identified among participants in the Danish cohort study "Diet, Cancer and Health" in which 57,053 50-64 years old persons were included 1993-7. Medical records were retrieved and reviewed by an experienced physician using a detailed standardized form, and information on the diagnostic work-up and presence...

  9. Oral contraceptives and venous thromboembolism: a five-year national case-control study

    DEFF Research Database (Denmark)

    Lidegaard, Øjvind; Edström, Birgitte; Kreiner, Svend

    2002-01-01

    Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare......Venous thromboembolism; Oral contraceptives; Pulmonary embolism; Third-generation; Second-generation; Pill Scare...

  10. Chronic inflammatory polyneuropathy

    Science.gov (United States)

    Polyneuropathy - chronic inflammatory; CIDP; Chronic inflammatory demyelinating polyneuropathy ... of the body equally. Chronic inflammatory demyelinating polyneuropathy (CIDP) is the most common chronic neuropathy caused by ...

  11. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  12. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  13. Anomalous azygos venous system in a south Indian cadaver: a case report

    OpenAIRE

    Quadros, Lydia S; Potu, Bhagath Kumar; Guru, Anitha; Pulakunta, Thejodhar; Ray, Biswabina; D'Silva, Suhani Sumalatha; Sequeira, Sylvia; Thomas, Huban

    2009-01-01

    Introduction The posterior thoracic wall, an area drained by the azygos venous system, is a common site for surgical intervention. Since the venous part of the cardiovascular system is subject to most common variation, abnormalities in the azygos venous system are often reported. Case presentation During routine dissection classes for undergraduate medical students, we encountered a variation in the azygos venous system in a 65 years old south Indian male cadaver. We observed that there was n...

  14. Abducens Palsy Due to Cerebral Venous Sinus Thrombosis in a Patient with Heart Failure

    OpenAIRE

    Cem Özgönül; Osman Melih Ceylan; Fatih Mehmet Mutlu

    2015-01-01

    Cerebral venous sinus thrombosis has a wide spectrum of presentation. The clinical manifestation depends on the location of the thrombus, its rate of progression, and the extent of venous collateralization. In this case report, we present the findings of cerebral venous sinus thrombosis presenting with abducens palsy and papilloedema in a patient with heart failure, an unusual etiology for cerebral venous sinus thrombosis. (Turk J Ophthalmol 2015; 45: 179-181)

  15. Risk factors for venous port migration in a single institute in Taiwan

    OpenAIRE

    Fan, Wen-Chieh; Wu, Cheng-Han; Tsai, Ming-Ju; Tsai, Ying-Ming; Chang, Hsu-Liang; HUNG, JEN-YU; Chen, Pei-Huan; Yang, Chih-Jen

    2014-01-01

    Background An implantable port device provides an easily accessible central route for long-term chemotherapy. Venous catheter migration is one of the rare complications of venous port implantation. It can lead to side effects such as pain in the neck, shoulder, or ear, venous thrombosis, and even life-threatening neurologic problems. To date, there are few published studies that discuss such complications. Methods This retrospective study of venous port implantation in a single center, a Taiw...

  16. Chronic Hemodialysis in Small Children.

    Science.gov (United States)

    Novljan, Gregor; Rus, Rina R; Premru, Vladimir; Ponikvar, Rafael; Battelino, Nina

    2016-06-01

    When peritoneal dialysis is inapplicable, chronic hemodialysis (HD) becomes the only available treatment option in small children. Due to small patient size, central venous catheters (CVC) are mainly used for vascular access. Over the past 4 years, four children weighing less than 15 kg received chronic HD in our unit. A total of 848 dialysis sessions were performed. Altogether, 21 catheters were inserted. In all but one occasion, uncuffed catheters were used. Catheter revision was performed 15 times during the study period, either due to infection or catheter malfunction. The median number of catheter revisions and the median line survival was 3.0/patient-year and 53 days (range; 6-373 days), respectively. There were 14 episodes of catheter related infections requiring 11 CVC revisions (78.6%). The median rate of line infections was 2.8/patient-year. Chronic HD in small children is demanding and labor intensive. Issues pertain mainly to CVCs and limit its long-term use. PMID:27312919

  17. Potential role of metalloproteinase inhibitors from radiation‑sterilized amnion dressings in the healing of venous leg ulcers.

    Science.gov (United States)

    Litwiniuk, Małgorzata; Bikowska, Barbara; Niderla-Bielińska, Justyna; Jóźwiak, Jarosław; Kamiński, Artur; Skopiński, Piotr; Grzela, Tomasz

    2012-10-01

    Chronic wounds are a significant socio-economic problem, thus, the improvement of the effectiveness of their treatment is an important objective for public health strategies. The predominant stage of the chronic wound is the inflammatory reaction which is associated with the damage of tissues, possibly due to the excessive secretion and activation of matrix metalloproteinases (MMPs). Several reports have suggested that amnion dressing inhibits tissue destruction and accelerates wound healing. Our recent study revealed that sterilized amnion stimulates keratinocyte proliferation in vitro, while the present study focused on the clinical application of radiation-sterilized amnion in chronic venous leg ulcers and aimed to explain the possible mechanism of its in vivo action. The study involved 25 individuals suffering from venous leg ulceration with a surface area of 10-100 cm2 and a healing rate below 10% per week, as verified during a 2-week screening period. The effectiveness of the amnion dressing was estimated following 4 weeks of treatment. The wound assessment, based on a modified Bates-Jensen Questionnaire, revealed a good and satisfactory response to the treatment in 23 of the 25 patients. The measurement of MMP-2 and MMP-9 activities in wound exudates revealed a decrease in activity in response to amnion application. This effect resulted from the presence of the potent MMP inhibitors, tissue inhibitor of metalloproteinases-1 (TIMP-1), type-1 plasminogen activator inhibitor (PAI-1) and thrombospondin-1 (TSP-1) in the amnion dressings, as shown by real-time fluorescence zymography and protein microarrays. Thus, unlike modern synthetic dressing materials, radiation-sterilized amnion dressings may have a multidirectional beneficial effect on chronic wounds. PMID:22798012

  18. Clinical Observation in 45 Cases of Hemorrhagic Apoplexy of the Acute Stage Treated by Promoting Blood Circulation and Removing Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    孙国柱

    2003-01-01

    To explore the therapeutic effects of the method of promoting blood circulation and removing blood stasis on hemorrhagic apoplexy of acute stage, 45 cases were treated by the method and observed for their conscious state and motor function, which were compared with 40 cases treated with regular western drugs. The results showed that the effective rate in the treated group was 82.2% and that in control group 60% with a significant difference (P<0.05) between the two groups. In the treated group, the scores of the conscious state and the motor function after treatment were elevated dramatically (P<0.01), indicating a much better effect in the treated group than in the control group.

  19. Non-local competition drives both rapid divergence and prolonged stasis in a model of speciation in populations with degenerate resource consumption

    Directory of Open Access Journals (Sweden)

    Atamas Nicholas

    2012-12-01

    Full Text Available Abstract The theory of speciation is dominated by adaptationist thinking, with less attention to mechanisms that do not affect species adaptation. Degeneracy – the imperfect specificity of interactions between diverse elements of biological systems and their environments – is key to the adaptability of populations. A mathematical model was explored in which population and resource were distributed one-dimensionally according to trait value. Resource consumption was degenerate – neither strictly location-specific nor location-independent. As a result, the competition for resources among the elements of the population was non-local. Two modeling approaches, a modified differential-integral Verhulstian equation and a cellular automata model, showed similar results: narrower degeneracy led to divergent dynamics with suppression of intermediate forms, whereas broader degeneracy led to suppression of diversifying forms, resulting in population stasis with increasing phenotypic homogeneity. Such behaviors did not increase overall adaptation because they continued after the model populations achieved maximal resource consumption rates, suggesting that degeneracy-driven distributed competition for resources rather than selective pressure toward more efficient resource exploitation was the driving force. The solutions were stable in the presence of limited environmental stochastic variability or heritable phenotypic variability. A conclusion was made that both dynamic diversification and static homogeneity of populations may be outcomes of the same process – distributed competition for resource not affecting the overall adaptation – with the difference between them defined by the spread of trait degeneracy in a given environment. Thus, biological degeneracy is a driving force of both speciation and stasis in biology, which, by themselves, are not necessarily adaptive in nature.

  20. Pharmacokinetic effect of activating blood and dissolving stasis of Nao-an capsule on anti-epilepsy drug VPA-Mg

    Institute of Scientific and Technical Information of China (English)

    Yu Xiangan(于香安); Zhou Suqin(周素琴); Luo Qin(骆勤); Ju Yang(鞠洋); Cai Huaiyou (蔡怀友)

    2003-01-01

    Objective: To investigate the pharmacokinetic effect of activating blood and dissolving stasis of Nap-an capsule onanti-epilepsy drug VPA-Mg. Methods: Nine rabbits were divided into tow groups: VPA group (group 1) and VPA with Nap-an group(group 2). Blood samples of the two groups were obtained and Fluorescence deflection libration immunity was employed to determinethe blood concentration at different time point. TDx and Reagent pack valproic acid were adopted to draw the drug-time curve and thepharmacokinetic parameters of the two groups were self-eross-compared. All date were processed with computer pharmacokineticsoftware 3P97. Results: All pharmacokinetic parameters of group 2 were significantly superior than those of group 1(P<0.05). Thevalue of A was increased from 65.86 (group 1) to 116.37 (group 2) (P<0.01). The area under the curve was increased from 6478.32(group 1) to 10202.55 (group 2). The value of Ka was increased from 0.067 (group l) to 0.1414 (group 2) (P<0.05), tp2 (Ka) wasadvanced from 11.92 (group 1) to 6.93 (group 2) (P<0.05). Tpeak was advanced from 44.73 (group 1) to 27.51 (group 2), Cmax wasincreased from 46.89 (group 1) to 87.66 (group 2) (P<0.05). The bioavailability ratio of the two groups were 1:1.57. Conclusion: Theactivating blood and dissolving stasis of drug Nan-an can significantly stimulate the absorption of anti-epilepsy drug VPA-Mg. Thisstudy by method of ECP proved that Chinese drug can significantly improve the blood circulation and stimulate the absorption of otherdrugs in treatment of epilepsy.