WorldWideScience

Sample records for chronic venous stasis

  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

    venous stasis. In another experimental series the effect of general pentobarbital anesthesia on the vasoconstrictor activity in response to venous stasis locally in subcutaneous and muscle tissue in the hind limb was examined in 6 dogs. It was found that during the first 2-3 h of anesthesia...... the 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...... response was demonstrated in the hindleg 1 h and 5 h after induction of the anesthesia. It is concluded that pentobarbital anesthesia abolishes the arteriolar constriction induced by venous stasis. The mechanism may be blockade of the local sympathetic vasoconstrictor fibres or interference with myogenic...

  2. Risk Factors in Patients with Venous Stasis-Related Skin Lesions without Major Abnormalities on Duplex Ultrasonography

    Science.gov (United States)

    Morikage, Noriyasu; Yamashita, Osamu; Harada, Takasuke; Samura, Makoto; Takeuchi, Yuriko; Mizoguchi, Takahiro; Hamano, Kimikazu

    2016-01-01

    Purpose: To clarify the risk factors for venous stasis-related skin lesions in the legs in patients without major abnormalities on duplex ultrasonography (DUS). Methods: Fifty patients (nine males and 41 females, age 27–93 years) with symptoms of C4 or greater according to the Clinical, Etiological, Anatomical, Pathological (CEAP) classification, but having no abnormalities on DUS were reviewed for known risk factors for chronic venous insufficiency (CVI) such as older age (>70 years), obesity (body mass index [BMI] >30 kg/m2), short walking distance (8h per day). Results: The risk factor was different between male and female patients; although all patients had at least one of the above risk factors, the most commonly found risk factor in male patients was occupation requiring prolonged standing (63%), while advanced age (78%) and limited walking distance (83%) were risk factors in female patients. Conclusions: Although male and female patients had different risk factors, insufficient walking seemed to be closely related to the development of venous stasis-related skin lesions. PMID:27738462

  3. 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

  4. Chronic Venous Disease under pressure

    OpenAIRE

    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 regard to non-healing and recurrence rates. Annually 6% of the total healthcare costs are spent on the treatment of venous diseases. CVD results from ambulatory venous hypertension and is the conse...

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

    OpenAIRE

    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...

  6. Doppler ultrasound study and venous mapping in chronic venous insufficiency.

    Science.gov (United States)

    García Carriazo, M; Gómez de las Heras, C; Mármol Vázquez, P; Ramos Solís, M F

    2016-01-01

    Chronic venous insufficiency of the lower limbs is very prevalent. In recent decades, Doppler ultrasound has become the method of choice to study this condition, and it is considered essential when surgery is indicated. This article aims to establish a method for the examination, including venous mapping and preoperative marking. To this end, we review the venous anatomy of the lower limbs and the pathophysiology of chronic venous insufficiency and explain the basic hemodynamic concepts and the terminology required to elaborate a radiological report that will enable appropriate treatment planning and communication with other specialists. We briefly explain the CHIVA (the acronym for the French term "cure conservatrice et hémodynamique de l'insuffisance veineuse en ambulatoire"=conservative hemodynamic treatment for chronic venous insufficiency) strategy, a minimally invasive surgical strategy that aims to restore correct venous hemodynamics without resecting the saphenous vein.

  7. 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...... aim was to assess the prevalence of CCSVI in Danish MS patients using sonography and compare these findings with MRI measures of venous flow and morphology....

  8. Chronic cerebrospinal venous insufficiency in patients with Ménière's disease.

    Science.gov (United States)

    Filipo, R; Ciciarello, F; Attanasio, G; Mancini, P; Covelli, E; Agati, L; Fedele, F; Viccaro, M

    2015-01-01

    To analyze the presence of chronic cerebrospinal venous insufficiency parameter and vascular abnormalities, in the internal jugular veins (IJVs) and/or vertebral veins in sitting and supine posture, in patients with Meniere's disease compared to healthy general population. A prospective study on 32 patients affected by definite Ménière was performed from February 2012 to January 2013. All subjects underwent an echo-color Doppler examination of the cerebrospinal venous flow. 21 of the 32 Menieric patients showed a statistically significant reflux in the intracranial veins versus healthy (65.6 vs 25%; P venous system present in patients affected by definite Meniere. This vascular impairment significantly affects the vascular areas more directly involved in the venous drainage of the inner ear. Thus venous stasis may be considered a further pathogenetic mechanism for development of Meniere's disease.

  9. The chronic cerebrospinal venous insufficiency syndrome.

    Science.gov (United States)

    Zamboni, P; Galeotti, R

    2010-12-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenosies of the internal jugular and/or azygous veins (IJVs-AZ) with opening of collaterals and insufficient drainage proved by reduced cerebral blood flow and increased mean transit time in cerebral MRI perfusional study. The present review is aimed to give a comprehensive overview of the actual status of the art of the diagnosis and treatment of this condition. As far as the origin of venous narrowing is concerned, phlebographic studies of the IJVs and AZ systems demonstrated that venous stenoses were likely to be truncular venous malformations; mostly, they are intraluminal defects such as malformed valve, septa webs. CCSVI condition has been found to be strongly associated with multiple sclerosis (MS), a disabling neurodegenerative and demyelinating disease considered autoimmune in nature. In several epidemiological observations performed at different latitudes on patients with different genetic backgrounds, the prevalence of CCSVI in MS ranges from 56% to 100%. To the contrary, by using venous MR and/or different Doppler protocols, CCSVI was not detected with the same prevalence. Two pilot studies demonstrated the safety and feasibility in Day Surgery of the endovascular treatment of CCSVI by means of balloon angioplasty (PTA). It determines a significant reduction of postoperative venous pressure. Restenosis rate was found out elevated in the IJVs, but negligible in the AZ. However, PTA seems to positively influence clinical and QoL parameters of the associated MS and warrants further randomized control trials.

  10. Chronic Infection and Venous Thromboembolic Disease.

    Science.gov (United States)

    Epaulard, Olivier; Foote, Alison; Bosson, Jean-Luc

    2015-09-01

    Venous thromboembolic disease often arises as a complication of another pathological condition and/or triggering event. Infectious diseases result from both the direct action of the pathogens themselves and their effect on the immune system. The resulting inflammatory process and the coagulation and fibrinolysis processes share common pathways, explaining why infection is associated with thrombosis. In this brief overview, besides certain chronic infectious diseases, we also consider some acute infections, as the mechanisms are likely to be similar, particularly in the initial infective stage or the more acute episodes of a chronic infection. The infectious agent can be viral, bacterial, fungal, or parasitic. However, the literature on the link between infections and venous thromboembolism (VTE) is uneven, favoring infections that are found in more developed countries where physicians have access to VTE diagnostic tools. Thus, large epidemiological studies in this field are restricted to a limited number of the common chronic infectious diseases such as tuberculosis, while for other infections, particularly parasitic and fungal infections, the link with VTE is only evoked in a few scattered case reports.

  11. 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

  12. 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.

  13. Compression therapies for chronic venous leg ulcers: interventions and adherence

    Directory of Open Access Journals (Sweden)

    Latz CA

    2015-01-01

    Full Text Available Christopher A Latz,1 Kellie R Brown,2 Ruth L Bush11Texas A&M Health Science Center College of Medicine, Bryan, TX, USA; 2Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Compression therapy has been the mainstay for the treatment of lower extremity edema, venous insufficiency, and particularly, venous ulcerative disease. Though modern surgical treatments exist, none are completely effective without good compressive options to allow for decreased swelling and better oxygenation of damaged tissues. This review article will describe the pathophysiology and presentation of lower extremity venous ulcerations, as well as current options for compression therapy. The benefits, along with the major pitfall of nonadherence, will also be discussed.Keywords: venous disease, chronic venous insufficiency, venous ulceration

  14. [Lower limb venous angiodysplasia as a cause of chronic venous insufficiency: specific diagnosis and treatment].

    Science.gov (United States)

    Dan, V N; Sapelkin, S V; Karmazanovskiĭ, G G; Kuntsevich, G I

    2007-01-01

    The paper presents a current understanding of chronic venous insufficiency that develops in venous forms of dysplasia. Management of venous dysplasia must be based on multidisciplinary approach including comprehensive diagnosis (predominantly noninvasive), integrative surgical and non-surgical treatment. Modern therapy must be complex and carried out in highly specialized facilities. Best functional and esthetic results can be achieved only through combined therapy. When surgical or non-surgical interventions are inappropriate or impossible, management focus must be placed on clinical control of vascular anomaly (follow-up and compression-based conservative treatment) aimed at minimization of its unfavorable impact on vital functions and at quality of life improvement.

  15. To what extent might deep venous thrombosis and chronic venous insufficiency share a common etiology?

    Science.gov (United States)

    Malone, P Colm; Agutter, P S

    2009-08-01

    According to the valve cusp hypoxia hypothesis (VCHH), deep venous thrombosis is caused by sustained non-pulsatile (streamline) venous blood flow. This leads to hypoxemia in the valve pockets; hypoxic injury to the inner (parietalis) endothelium of the cusp leaflets activates the elk-1/egr-1 pathway, leading to leukocyte and platelet swarming at the site of injury and, potentially, blood coagulation. Here, we propose an extension of the VCHH to account for chronic venous insufficiency. First, should the foregoing events not proceed to frank thrombogenesis, the valves may nevertheless be chronically injured and become incompetent. Serial incompetence in lower limb valves may then generate ''passive'' venous hypertension. Second, should ostial valve thrombosis obstruct venous return from muscles via tributaries draining into the femoral vein, as Virchow illustrated, ''active'' venous hypertension may supervene: muscle contraction would force the blood in the vessels behind the blocked ostial valves to re-route. Passive or active venous hypertension opposes return flow, leading to luminal hypoxemia and vein wall distension, which in turn may impair vasa venarum perfusion; the resulting mural endothelial hypoxia would lead to leukocyte invasion of the wall and remodelling of the media. We propose that varicose veins result if gross active hypertension stretches the valve ''rings'', rendering attached valves incompetent caudad to obstructed sites, replacing normal centripetal flow in perforating veins with centrifugal flow and over-distending those vessels. We also discuss how hypoxemia-related venous/capillary wall lesions may lead to accumulation of leukocytes, progressive blockage of capillary blood flow, lipodermosclerosis and skin ulceration.

  16. Endovascular therapy for chronic cerebrospinal venous insufficiency in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Marc A. Lazzaro

    2011-07-01

    Full Text Available Recent reports have emerged suggesting that multiple sclerosis (MS may be due to abnormal venous outflow from the central nervous system, termed Chronic Cerebrospinal Venous Insufficiency (CCSVI. These reports have generated strong interest and controversy over the prospect of a treatable cause of this chronic debilitating disease. This review aims to describe the proposed association between CCSVI and MS, summarize the current data, and discuss the role of endovascular therapy and the need for rigorous randomized clinical trials to evaluate this association and treatment.

  17. 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.

  18. 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.

  19. Clinical correlates of chronic cerebrospinal venous insufficiency in multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Weinstock-Guttman Bianca

    2012-05-01

    Full Text Available Abstract Background Chronic cerebrospinal venous insufficiency (CCSVI is a vascular condition characterized by anomalies of the primary veins outside the skull that has been reported to be associated with MS. In the blinded Combined Transcranial (TCD and Extracranial Venous Doppler Evaluation (CTEVD study, we found that prevalence of CCSVI was significantly higher in multiple sclerosis (MS vs. healthy controls (HC (56.1% vs. 22.7%, p  The objective was to evaluate the clinical correlates of venous anomalies indicative of CCSVI in patients with MS. Methods The original study enrolled 499 subjects; 163 HC, 289 MS, 21 CIS and 26 subjects with other neurological disorders who underwent a clinical examination and a combined Doppler and TCD scan of the head and neck. This analysis was restricted to adult subjects with MS (RR-MS: n = 181, SP-MS: n = 80 and PP-MS: n = 12. Disability status was evaluated by using the Kurtzke Expanded Disability Status Scale (EDSS and MS severity scale (MSSS. Results Disability was not associated with the presence (≥2 venous hemodynamic criteria or the severity of CCSVI, as measured with venous hemodynamic insufficiency severity score (VHISS. However, the severity of CCSVI was associated with the increased brainstem functional EDSS sub-score (p = 0.002. In logistic regression analysis, progressive MS (SP-MS or PP-MS vs. non-progressive status (including RR-MS was associated with CCSVI diagnosis (p = 0.004, OR = 2.34, CI = 1.3–4.2. Conclusions The presence and severity of CCVSI in multiple sclerosis correlate with disease status but has no or very limited association with clinical disability.

  20. Review of venous anatomy for venographic interpretation in chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Werner, John D; Siskin, Gary P; Mandato, Kenneth; Englander, Meridith; Herr, Allen

    2011-12-01

    Chronic cerebrospinal venous insufficiency (CCSVI) represents a recently described condition that may potentially contribute to the symptoms experienced by patients with multiple sclerosis. The evaluation of a prospective patient for CCSVI often involves an invasive evaluation with venography of the internal jugular and azygos veins. The purpose of this article is to review the normal anatomy of the internal jugular, vertebral, and azygos veins, as an understanding of these veins is necessary for appropriate interpretation of the venograms obtained to evaluate patients for CCSVI.

  1. Catheter venography and endovascular treatment of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Mandato, Kenneth; Englander, Meridith; Keating, Lawrence; Vachon, Jason; Siskin, Gary P

    2012-06-01

    Multiple sclerosis (MS) is a disorder characterized by damage to the myelin sheath insulation of nerve cells of the brain and spinal cord affecting nerve impulses which can lead to numerous physical and cognitive disabilities. The disease, which affects over 500,000 people in the United States alone, is widely believed to be an autoimmune condition potentially triggered by an antecedant event such as a viral infection, environmental factors, a genetic defect or a combination of each. Chronic cerebrospinal venous insufficiency (CCSVI) is a condition characterized by abnormal venous drainage from the central nervous system that has been theorized to have a possible role in the pathogenesis and symptomatology of MS (1). A significant amount of attention has been given to this theory as a possible explanation for the etiology of symptoms related to MS patients suffering from this disease. The work of Dr. Zamboni, et al, who reported that treating the venous stenoses causing CCSVI with angioplasty resulting in significant improvement in the symptoms and quality of life of patients with MS (2) has led to further interest in this theory and potential treatment. The article presented describes endovascular techniques employed to diagnose and treat patients with MS and CCSVI.

  2. 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

  3. Treatment of chronic venous leg ulcers by platelet gel.

    Science.gov (United States)

    Ficarelli, Elena; Bernuzzi, Gino; Tognetti, Elena; Bussolati, Ovidio; Zucchi, Alfredo; Adorni, Daniela; De Panfilis, Giuseppe

    2008-07-01

    Chronic venous leg ulcers (CVLU) are chronic wounds, associated with long-standing venous hypertension, which have a poor prognosis for healing. In the process of wound healing the first step is represented by platelet aggregation and subsequent release of growth factors and other mediators, which play a key role in the repair response. Platelet gel (PG), a hemocomponent obtained by mixing platelets, thrombin, and calcium, is able, when applied topically, to release platelet mediators that likely favor CVLU healing. However, unstandardized protocols have been described in studies utilizing PG for the regeneration of a number of tissues, including CVLU; the relative clinical outcomes were hence highly variable. In our experience the topical use of PG, together with the strict adherence to the principles of good wound care, quickly promoted increased granulation tissue, followed by a complete CVLU epithelization. Although further studies and trials are needed to establish the major outcome affecting rules for optimal indications, preparation, and use of PG for CVLU treatment, PG can be undoubtedly considered a useful tool, able to improve the management of CVLU.

  4. Local Treatment of Chronic Wounds in Patients With Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes

    NARCIS (Netherlands)

    Ruettermann, Mike; Maier-Hasselmann, Andreas; Nink-Grebe, Brigitte; Burckhardt, Marion

    2013-01-01

    Background: A chronic wound is defined as an area where the skin is not intact that fails to heal within eight weeks. Such wounds usually develop on the lower limbs as a complication of diabetes, venous insufficiency, or inadequate arterial perfusion. Most of the roughly 45 000 limb amputations perf

  5. Retinal abnormalities in multiple sclerosis patients with associated chronic cerebrospinal venous insufficiency

    OpenAIRE

    Aneta Adamczyk-Ludyga; Justyna Wróbeł; Marian Simka; Tomasz Ludyga; Paweł Latacz; Marek Kazibudzki

    2012-01-01

    Optical coherence tomography (OCT) is a non-invasive method for the assessment of optic nerve fibers and retinal ganglion cells. This study was aimed at the assessment of retinal abnormalities in multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency using OCT of the retina and the optic nerve. We examined 239 multiple sclerosis (MS) patients, including 220 patients with associated chronic cerebrospinal venous insufficiency and 19 MS patients without venous p...

  6. 77 FR 24718 - Scientific Information Request on Chronic Venous Ulcers Treatments

    Science.gov (United States)

    2012-04-25

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Scientific Information Request on Chronic... for Scientific Information Submissions. SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is seeking scientific information submissions from manufacturers of chronic venous ulcer...

  7. 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.

  8. [The peculiarities of diagnosis and treatment of chronic venous insufficiency and venous forms of lower extremity dysplasia].

    Science.gov (United States)

    Sapelkin, S V; Dan, V N; Karmazanovskĭ, G G; Kuntsevich, G I

    2006-12-01

    The authors present the modern viewpoint concerning the problem of chronic venous insufficiency in the cases of venous forms of dysplasia. The treatment of patients with of venous forms of dysplasia should be based on the principles of interdisciplinary approach, which stipulates both the careful diagnosis on the basis of mainly non-invasive methods and integration of surgical and conservative treatment methods. Today such treatment should be combined and conducted within the multi-purpose highly specialized institution. Only the combination of all treatment methods will allow achieving the best functional and esthetic results. In the cases when indications are absent and conduction of surgical or any other treatment method is impossible it is necessary control the venous anomaly (dynamical follow-up, compression as a basic variant of conservative therapy). It will allow minimizing the unfavorable influence on vital functions and improving the patient's life quality.

  9. Nursing diagnoses in patients with chronic venous ulcer: observational study

    Directory of Open Access Journals (Sweden)

    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  10. Smart medical stocking using memory polymer for chronic venous disorders.

    Science.gov (United States)

    Kumar, Bipin; Hu, Jinlian; Pan, Ning

    2016-01-01

    Proper level of pressure or compression generated by medical stocking or hosiery is the key element for successful treatment or management of chronic venous disorders such as oedema, leg ulcers, etc. However achieving the recommended compression level and, more importantly, sustaining it using stockings has been a major challenge to the health practitioners supervising the treatment. This work aims to investigate and design a smart compression stocking using shape-memory polymer that allows externally controlling the pressure level in the wrapped position on the leg. Based on thermodynamical rubber theories, we first derived several criteria that have to be satisfied simultaneously in order to achieve the controlled pressure adjustment using external heat stimuli. We then presented a case where such a stocking is developed using a blend yarn consists of selected shape-memory polyurethane and nylon filaments. Extensive experimental work has also been conducted to demonstrate the feasibility and explore the influencing factors involved.

  11. 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.

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

    Science.gov (United States)

    Pesta, Wiesław; Kurpiewski, Waldemar; Kowalczyk, Marek; Szynkarczuk, Rafał; Luba, Magdalena; Zurada, Anna; Grabysa, Radosław

    2011-12-01

    In spite of medical science development and initiation of new technologies in minimally invasive surgery, treatment of advanced chronic venous insufficiency at the 5(th) and 6(th) 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 reducing venous pressure in the superficial venous system could provide healing of the recurrent venous ulcer. In this study we present a review of contemporary opinions about the place and significance of subfascial endoscopic perforator vein surgery as a treatment of advanced chronic venous insufficiency.

  13. Endovascular Interventions for Acute and Chronic Lower Extremity Deep Venous Disease: State of the Art.

    Science.gov (United States)

    Sista, Akhilesh K; Vedantham, Suresh; Kaufman, John A; Madoff, David C

    2015-07-01

    The societal and individual burden caused by acute and chronic lower extremity venous disease is considerable. In the past several decades, minimally invasive endovascular interventions have been developed to reduce thrombus burden in the setting of acute deep venous thrombosis to prevent both short- and long-term morbidity and to recanalize chronically occluded or stenosed postthrombotic or nonthrombotic veins in symptomatic patients. This state-of-the-art review provides an overview of the techniques and challenges, rationale, patient selection criteria, complications, postinterventional care, and outcomes data for endovascular intervention in the setting of acute and chronic lower extremity deep venous disease. Online supplemental material is available for this article.

  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. The role of perforators in chronic venous insufficiency.

    Science.gov (United States)

    O'Donnell, T F

    2010-02-01

    The treatment of incompetent calf perforating veins (ICPVs) has been ascribed an important role in the therapeutic strategy for reducing superficial venous hypertension in patients with advanced chronic venous insufficiency (C4-C6). Since the open approach to ligation of ICPVs was developed by Linton over 70 years ago, there has been an evolution toward less invasive techniques with lower morbidity. This paper will review the evidence for interruption of ICPVs through a series of systematic analyses of (1) subfascial endoscopic perforating surgery (SEPS) and (2) percutaneous thermal ablation techniques (PAPS). The effectiveness and morbidity of each approach will be discussed as well as the strength of evidence supporting that technique. While there are numerous case series that suggest that SEPS is beneficial for ulcer healing and for the prevention of ulcer recurrence, the sole two RCTs that have compared either open division or SEPS for ICPVs have failed to show a statistical advantage for ICPV ablation. The results of these studies are clouded by the inclusion of patients who received concomitant treatment of their great saphenous vein (GSV). The evidence for PAPS is based on a few (n = 5) case series in peer-reviewed journals, which are limited by small patient populations, limited follow-up, and a focus on surrogate outcomes (occlusion of the perforator) rather than clinical or functional outcomes. Moreover, most of these series were carried out in patients with mild disease. Sclerotherapy of ICPVs, by either liquid or foam, shows promise, but requires greater evidence. Our current approach for limbs with C4-C6 disease is to treat the GSV first and limit treatment of ICPVs to those with high volume flow and large-diameter ICPVs. [corrected

  16. 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

  17. [Clinico-histopathological correlations of venous wall modifications in chronic venous insufficiency].

    Science.gov (United States)

    Mironiuc, A; Palcau, L; Andercou, O; Rogojan, L; Todoran, M; Gordan, G

    2008-01-01

    The interest manifested for the conjunctive tissue pathology leaded to the study of the structural disorder that appears in the varicose veins walls. The study is a prospective one initiated in March 2007 made on 11 patients with varicose disease hospitalized at Cluj-Napoca within Surgery Clinic no. II. The purpose of this study is to point out the histopathological modifications in the varicose venous wall (great saphenous vein cross, communicating veins, perforating veins), as well as the correlation of histopathological results with the evolutive stage of chronic vein insufficiency (CEAP classification) and with the clinical score at these patients. The histopathological (HP) results for 2 of the patients revealed hypertrophy of the media, intimal hyperplasia (stage II) corresponding to a CEAP 3. Six patients were integrated in HP stage III due to the partial intimal fibrosis corresponding to a CEAP 6 for one case, CEAP 4 one case, CEAP 3 four cases. One patient had HP stage I with CEAP 3 and two patients had HP stage IV corresponding to CEAP 5, respectively CEAP 6.

  18. [Disorders of statics of the foot and chronic venous insufficiency].

    Science.gov (United States)

    Peresa, M; Krajcar, J

    1987-01-01

    The aim of this study was to confirm a fact known in the relevant literature that there is a correlation between static anomalies of the sole, and varicose veins, a consequence of the decreased quality of the conjunctive tissue. We cite genetic and dynamic factors by way of explanation. To confirm the fact that deformities of the sole of the foot are linked with chronic venous incompetence and influence the functional capacity of the muscular pump, the authors have analysed in young subjects the contractile capacity of the pump even when the index of reduction in the sole of the foot was quite low. The muscular pump in the calf is a compensatory system from the point of view of functional capacity. The authors noted that the velocimetric parameter of speed of flux in the femoral vein is a sensitive parameter and changes rapidly, rising with even minimal activity in the calf. The authors think that acquired deformities are one of the most frequent causes of the poor functioning of the muscular pump in the calf.

  19. Chronic venous disease - Part I: Inflammatory biomarkers in wound healing.

    Science.gov (United States)

    Ligi, Daniela; Mosti, Giovanni; Croce, Lidia; Raffetto, Joseph D; Mannello, Ferdinando

    2016-10-01

    Venous leg ulcers (VLUs) produce wound fluid (WF), as a result of inflammatory processes within the wound. It is unclear if WF from different healing phases of VLU has a peculiar biochemical profile and how VLU microenvironment affects the wound healing mechanisms. This study was conducted to evaluate the cytokine/chemokine profiles in WF from distinct VLU phases, in WF- and LPS-stimulated monocytes and treated with glycosaminoglycan Sulodexide, a therapeutic option for VLU healing. WF and plasma were collected from patients with VLU during active inflammatory (Infl) and granulating (Gran) phases. Demographics, clinical characteristics and pain measurements were evaluated. WF, plasma, and THP-1 supernatants were analyzed for 27 inflammatory mediators by multiplex immunoassay. Our results demonstrated that: 1) pain was significantly increased in patients with Infl compared to Gran VLU; 2) cytokine profile of Infl WF was found to be statistically different from that Gran WF, as well significantly increased respect to plasma; 3) LPS- and WF-stimulation of THP-1 cells significantly increased the expression of several cytokines compared to untreated cells; 4) Sulodexide treatment of both LPS- and WF-stimulated THP-1 monocytes was able to significantly down-regulate the release of peculiar inflammatory mediators. Our study highlighted the importance to understand biomolecular processes underlying CVI when providing treatment for chronic VLU. Identification of inflammatory biomarkers in leg ulcer microenvironment, may provide useful tools for predicting healing outcome and developing targeted therapies.

  20. Efficacy and safety of Chinese herbal medicine for chronic prostatitis associated with damp-heat and blood-stasis syndromes: a meta-analysis and literature review

    Science.gov (United States)

    Wang, Zhiqiang; Yuan, Lei; Wang, Yongchuan; Yang, Baizhi; Dong, Xiaohong; Gao, Zhaowang

    2016-01-01

    Objective The aim of this meta-analysis and systematic review is to evaluate the safety and efficacy of Chinese herbal medicine (CHM) for chronic prostatitis (CP) associated with damp-heat and blood-stasis syndromes. Methods An electronic search of 13 databases up to May 2016 was screened to identify randomized controlled trials comparing the safety and efficacy of CHM for the treatment of CP associated with damp-heat and blood-stasis syndromes. Studies reporting on effective rates, adverse events, National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) scores, and symptom index of Chinese medicine for chronic prostatitis (SI-CM) scores as outcomes were included in the analysis. Data were analyzed by fixed- or random-effect models using the Review Manager software. Results Thirteen articles with the modified Jadad score ≥4 were identified. It was found that CHM was superior to placebo in increasing the efficacy (odds ratio: 6.72, 95% confidence interval [CI]: 2.78–9.48, P<0.00001) and reducing the SI-CM scores (standardized mean difference: −1.08, 95% CI: −1.35 to −0.81, P<0.00001). Oral CHMs were significantly more effective than placebo at reducing NIH-CPSI scores, with a mean difference of −1.39 (95% CI: −1.87 to −0.92, P<0.00001). Nevertheless, no significant differences were found between Prostant and placebo (standardized mean difference: −0.23, 95% CI: −0.46 to 0.01, P=0.06). The frequency of adverse events associated with oral CHM was similar to that associated with placebo (risk ratio: 1.36, 95% CI: 0.72–2.55, P=0.34) and less than that associated with Prostant (risk ratio: 1.63, 95% CI: 1.14–2.34, P=0.008). Conclusion Our novel analysis demonstrates that CHM ranks highest in terms of improvement of CP associated with damp-heat and blood-stasis syndromes. While Prostant showed some efficacy in this disorder, it was associated with a smaller reduction in NIH-CPSI scores. In conclusion, CHM monotherapy is safe and

  1. Computed Tomograpy Venography diagnosis of iliocaval venous obstruction in advanced chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Fabio Henrique Rossi

    2014-12-01

    Full Text Available Objective:Iliocaval obstruction is associated with venous hypertension symptoms and may predispose to deep venous thrombosis (DVT. Ultrasonography may fail to achieve noninvasive diagnosis of these obstructions. The possibility of using Computed Tomography Venography (CTV for these diagnoses is under investigation.Methods:Patients with CVI graded at CEAP clinical classes 3 to 6 and previous treatment failure underwent evaluation with CTV. Percentage obstruction was rated by two independent examiners. Obstruction prevalence and its associations with risk factors and CEAP classification were analyzed.Results:A total of 112 limbs were prospectively evaluated. Mean patient age was 55.8 years and 75.4% were women. Obstructions involved the left lower limb in 71.8% of cases and 35.8% of patients reported a medical history of deep venous thrombosis. Overall, 57.1% of imaging studies demonstrated venous obstruction of at least 50% and 10.7% showed obstruction of >80%. The only risk factor that was found to be independently associated with a significantly higher incidence of >50% venous obstruction was a medical history of DVT (p=0.035 (Fisher's exact test. There was a positive relationship between clinical classification (CEAP and degree of venous obstruction in the limbs studied (Chi-square test for linear trend; p=0.011.Conclusion:Patients with advanced CVI are often affected by obstructions in the iliocaval venous territory and CTV is able to diagnose the degree of obstruction. There is a positive association between degree of obstruction and both previous history of DVT and severity of symptoms of CVI.

  2. Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF).

    Science.gov (United States)

    Bush, Ronald; Comerota, Anthony; Meissner, Mark; Raffetto, Joseph D; Hahn, Steven R; Freeman, Katherine

    2017-04-01

    Scope A systematic review of the clinical literature concerning medical management of chronic venous disease with the venoactive therapy Micronized Purified Flavonoid Fraction was conducted in addition to an investigation of the hemodynamics and mechanism of chronic venous disease. Methods The systematic review of the literature focused on the use of Micronized Purified Flavonoid Fraction (diosmin) which has recently become available in the US, in the management of chronic venous disease. The primary goal was to assess the level of evidence of the role of Micronized Purified Flavonoid Fraction in the healing of ulcers, and secondarily on the improvement of the symptoms of chronic venous disease such as edema. An initial search of Medline, Cochrane Database for Systematic Reviews and Google Scholar databases was conducted. The references of articles obtained in the primary search, including a Cochrane review of phlebotonics for venous insufficiency, were reviewed for additional studies. Studies were included if patients had a diagnosis of chronic venous disease documented with Doppler and Impedance Plethysmography. Studies excluded were those that had patients with arterial insufficiency (Ankle Brachial Index chronic venous disease patients because of its favorable safety profile. The Working Group for chronic venous disease concurs with previous guidance by the International European Society for Vascular Surgery in 2015 which recommended the use of Micronized Purified Flavonoid Fraction for the healing of venous ulcers, alone and adjunctive to compression therapy, and for the reduction in symptoms of chronic venous disease such as edema.

  3. Efficacy and safety of Chinese herbal medicine for chronic prostatitis associated with damp-heat and blood-stasis syndromes: a meta-analysis and literature review

    Directory of Open Access Journals (Sweden)

    Wang Z

    2016-09-01

    Full Text Available Zhiqiang Wang,1 Lei Yuan,1 Yongchuan Wang,2 Baizhi Yang,1 Xiaohong Dong,1 Zhaowang Gao3 1Department of Urology, Shouguang Hospital of Traditional Chinese Medicine, Shouguang, 2Department of Urology, Weifang Traditional Chinese Hospital, Weifang, 3Department of Urology, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Shandong, People’s Republic of China Objective: The aim of this meta-analysis and systematic review is to evaluate the safety and efficacy of Chinese herbal medicine (CHM for chronic prostatitis (CP associated with damp-heat and blood-stasis syndromes.Methods: An electronic search of 13 databases up to May 2016 was screened to identify randomized controlled trials comparing the safety and efficacy of CHM for the treatment of CP associated with damp-heat and blood-stasis syndromes. Studies reporting on effective rates, adverse events, National Institutes of Health chronic prostatitis symptom index (NIH-CPSI scores, and symptom index of Chinese medicine for chronic prostatitis (SI-CM scores as outcomes were included in the analysis. Data were analyzed by fixed- or random-effect models using the Review Manager software.Results: Thirteen articles with the modified Jadad score ≥4 were identified. It was found that CHM was superior to placebo in increasing the efficacy (odds ratio: 6.72, 95% confidence interval [CI]: 2.78–9.48, P<0.00001 and reducing the SI-CM scores (standardized mean difference: -1.08, 95% CI: -1.35 to -0.81, P<0.00001. Oral CHMs were significantly more effective than placebo at reducing NIH-CPSI scores, with a mean difference of -1.39 (95% CI: -1.87 to -0.92, P<0.00001. Nevertheless, no significant differences were found between Prostant and placebo (standardized mean difference: -0.23, 95% CI: -0.46 to 0.01, P=0.06. The frequency of adverse events associated with oral CHM was similar to that associated with placebo (risk ratio: 1.36, 95% CI: 0.72–2.55, P=0.34 and less than that

  4. Inverse relation between aldosterone and venous capacitance in chronically treated congestive heart failure.

    Science.gov (United States)

    Rietzschel, E; Duprez, D A; De Buyzere, M L; Clement, D L

    2000-04-15

    The purpose of this study was to examine if there is a relation between the aldosterone escape phenomenon and venous capacitance of the upper and lower limbs in patients with long-term congestive heart failure (CHF) receiving chronic treatment with angiotensin-converting enzyme (ACE) inhibitors. The study group consisted of 16 subjects with ischemic CHF in New York Heart Association functional class II (age 59 +/-2 years, ejection fraction 24+/-4%), stabilized under a constant drug regimen comprising furosemide, captopril 50 mg 3 times daily, and digoxin for at least 3 months. Thirteen apparently healthy volunteers, aged 50+/-4 years acted as controls. Forearm and calf venous capacitances were measured simultaneously by venous occlusion plethysmography using mercury-in-silastic strain gauges. The equilibration technique was used to derive venous capacitance from the recorded pressure-volume curves. Active renin, angiotensin II, and aldosterone levels were determined on venous blood samples obtained in the supine position. Angiotensin II (paldosterone (paldosterone escape phenomenon). In CHF, forearm venous capacitance was 2.19+/-0.18 ml/100 ml; calf venous capacitance was 2.83+/-0.27 ml/100 ml. Aldosterone significantly and inversely correlated with venous capacitance in both upper (r = -0.586; p = 0.017) and lower (r = -0.625; p = 0.01) limbs. No correlations were found between forearm or calf venous capacitance and renin or angiotensin II. In patients with heart failure chronically treated with diuretics and full ACE inhibition, venous capacitance is inversely correlated with aldosterone through the mechanism of aldosterone escape, creating the potential for further deterioration of the CHF process.

  5. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Gizzi, G; Ippolito, E; Fano, F; Dugall, M; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2006-01-01

    The aim of this study was to investigate the clinical efficacy of oral Pycnogenol (Horphag Research Ltd, UK) in patients with severe chronic venous insufficiency. Patients with severe venous hypertension (chronic venous insufficiency, ankle swelling) and history of venous ulcerations were treated with Pycnogenol. Patients received oral Pycnogenol (50 mg capsules, 3 times daily for a total of 150 mg daily) for 8 weeks. A group of 21 patients was included in the treatment group and 18 equivalent patients were observed as controls (no treatment during the observation period). All 21 patients (age 53 years; range, 42-60 years; M:F=11:10) in the treatment group completed the 8-week study. Also the 18 controls completed the follow-up period. There were no drop-outs. The average ambulatory venous pressure was 59.3 (SD 7.2; range 50-68) with a refilling time shorter than 10 seconds (average 7.6; SD 3). There were no differences in ambulatory venous pressure or refilling time between the treatment and control patients. The duration of the disease-from the first signs/symptoms-was on average 5.7 years (SD 2.1). At 4 and 8 weeks, in all Pycnogenol-treated subjects, microcirculatory and clinical evaluations indicated a progressive decrease in skin flux, indicating an improvement in the level of microangiopathy; a significant decrease in capillary filtration; a significant improvement in the symptomatic score; and a reduction in edema. There were no visible effects in controls. In conclusion, this study confirms the fast clinical efficacy of Pycnogenol in patients with chronic venous insufficiency and venous microangiopathy. The study indicates the significant clinical role of Pycnogenol in the management, treatment and control of this common clinical problem. The treatment may be also useful to prevent ulcerations by controlling the level of venous microangiopathy.

  6. A Clinical Study on the Treatment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

    Institute of Scientific and Technical Information of China (English)

    SHEN Bi-qiong; SITU Yi; HUANG Jian-ling; SU Xiao-mei; HE Wei-tang; ZHANG Mao-wei; CHEN Qu-bo

    2005-01-01

    Objective: To observe the clinical efficacy of Penyanqing Capsule (盆炎清胶囊, PYQC) in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods: The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets (妇炎康片, FYKT) 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results: The total effective rate in the treated group was 83.3 %, which was insignificantly different from that in the control group ( 77.5 %, P > 0.05 ).However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion: PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

  7. Surgical treatment of severe chronic venous insufficiency caused by pulsatile varicose veins in a patient with tricuspid regurgitation.

    Science.gov (United States)

    Casian, D; Gutsu, E; Culiuc, V

    2009-04-01

    A case of severe chronic venous insufficiency caused by pulsatile varicose veins in a 46-year-old man with tricuspid regurgitation is presented. Active venous leg ulcer complicated with recurrent venous bleeding and inefficacy of conservative management serve as indications for surgical treatment. This case demonstrates the possibility of radical surgical correction of pathological venous reflux by means of saphenofemoral ligation, foam sclerotherapy and subfascial endoscopic perforator surgery.

  8. Acute on Chronic Venous Thromboembolism on Therapeutic Anticoagulation

    Directory of Open Access Journals (Sweden)

    Byron Bassi

    2013-01-01

    Full Text Available A case of proximal venous thromboembolism in a patient who presented to the ED with lower extremity pain is presented. Making this diagnosis is very important as fifty percent of patients with symptomatic proximal DVTs will go on to develop PE without treatment. This report underscores the utility of bedside ultrasonography in the emergency department.

  9. 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.

  10. Retinal abnormalities in multiple sclerosis patients with associated chronic cerebrospinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Aneta Adamczyk-Ludyga

    2012-06-01

    Full Text Available Optical coherence tomography (OCT is a non-invasive method for the assessment of optic nerve fibers and retinal ganglion cells. This study was aimed at the assessment of retinal abnormalities in multiple sclerosis patients in the context of chronic cerebrospinal venous insufficiency using OCT of the retina and the optic nerve. We examined 239 multiple sclerosis (MS patients, including 220 patients with associated chronic cerebrospinal venous insufficiency and 19 MS patients without venous pathology. The following OCT parameters were assessed: average ganglion cell complex thickness, global loss volume, focal loss volume and average retinal nerve fibre layer thickness. Abnormalities in the azygous and internal jugular veins were evaluated using catheter venography. We found a higher prevalence of abnormal OCT parameters in the patients with previous history of optic neuritis, not only on the side of inflammatory event, but also in the contralateral eye, which is in line with already existing body of evidence. The new and intriguing discovery is that we found statistically significant higher prevalence of abnormal OCT values in multiple sclerosis patients with unilateral stenosis of internal jugular vein. Patients who were not found venous abnormalities, as well as those presenting with pathologic azygous or bilateral internal jugular venous outflows, did not demonstrate a changed frequency of abnormal OCT parameters. Potential association between venous malformations and eye manifestations of multiple sclerosis, as has been demonstrated in this report, justifies further studies on this topic.

  11. Chronic venous insufficiency patterns in lower extremity veins detected by Doppler Ultrasound

    Directory of Open Access Journals (Sweden)

    Özhan Özgür

    2013-12-01

    Full Text Available Objective: The aim of this study was to reveal patterns ofchronic venous insufficiency of lower extremity detectedby color Doppler ultrasound and clarify its clinical implicationsin the patients with varicose veins symptoms.Methods: Between 2006 to 2011, a total of 2006 patientspresented with symptoms of venous insufficiency wereincluded in study. A total of 3938 lower extremity venoussystems were examined using color Doppler US. Weclassified four patterns considering combinations of superficialand deep venous insufficiency.Results: Of 2006 patients, 966 had either single venousinsufficiency (790, 82% or combined insufficiency (176,18%. Superficial venous insufficiency was observedat the saphenoefemoral junction (SFJ in 25.5%, at theGreat Saphenous Vein (GSV in 57.6%, at the GiacominiVein in 2.4%, at the saphenopopliteal junction in 1.8% andfinally at the Small Saphenous Vein (SSV in 9.1% of thepatients. We found multilevel venous insufficiency showingconnections at the rate of 51%. We described fourpatterns as Pattern 1: SFJ insufficiency combined withGSV (97.9%, GSV branching (7.1%, and perforatingvein (20.8% insufficiency, Pattern 2: Deep venous insufficiencycombined with SFJ (63.6%, GSV (76.4%, andSSV (16.4% insufficiency, Pattern 3: SPJ insufficiencycombined with SSV insufficiency (95.5% and Pattern 4:Giacomini Vein insufficiency combined with GSV (67.9%and SSV (75% insufficiency.Conclusion: Chronic venous insufficiency may show fourdifferent patterns. Our results revealed that SFJ and GSVinsufficiency combination and deep venous insufficiencyand GSV insufficiency combinations are the most commoninsufficiency patterns seen in lower extremity.Key words: Doppler ultrasound, varicose veins, venous insufficiency

  12. 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.

  13. Chronic kidney disease stages 1-3 increase the risk of venous thrombosis

    NARCIS (Netherlands)

    Ocak, G.; Verduijn, M.; Vossen, C. Y.; Lijfering, W. M.; Dekker, F. W.; Rosendaal, F. R.; Gansevoort, R. T.; Mahmoodi, B. K.

    2010-01-01

    P>Background: End-stage renal disease has been associated with venous thrombosis (VT). However, the risk of VT in the early stages of chronic kidney disease (CKD) has not yet been investigated. The aim of this study was to investigate whether CKD patients with stage 1-3 disease are at increased risk

  14. [EXPERIENCE OF SEVERE CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES TREATMENT].

    Science.gov (United States)

    Ponomarenko, A V

    2015-06-01

    The results of treatment of 246 patients on different forms of chronic venous insufficiency of the lower extremities were presented. The leading diagnostic criterion when choosing tactics consider patients ultrasound duplex scanning with color mapping. Patients in the presence of large ulcers basic treatment is autodermoplasty. The complex treatment include pharmacotherapy, the use of elastic compression hosiery.

  15. 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.

  16. 慢性关节炎宜从“血瘀”论治%DiscussionontheTreatmentofChronicArthritisbyBloodStasis

    Institute of Scientific and Technical Information of China (English)

    成源; 丰杰; 姚琴; 吴玉华; 赵凤新

    2013-01-01

    Objective  The article is to investigate the treatment of chronic arthritis.  Methods  It can be concluded that the treatment of chronic arthritis is not only through the research on the pathogenesis and etiology, but also by the Pathology and clinical study. Results  Blood stasis syndrome type is ubiquity in the pathological change of chronic arthritis. The disease is mainly due to the stagnation of blood, not seem to be caused by the wind, cold, or humidity. The mechanism of chronic arthritis is the main and collateral channels blockage, deifciency origin and excess in superifciality. Conclusion  The treatment of chronic arthritis is not only by nourishing liver and kidney and removing the wind, humidity and cold. But also should have seized the main contradiction of the disease, and the key is to remove the blood stasis.%  目的 探讨慢性关节炎的治疗方法。方法 通过对其病因病机分析和病理学、临床实践研究结论进行归纳。结果 “血瘀”是慢性关节炎中普遍存在的病理改变,该病以血瘀为本,风、寒、湿为标,经络痹阻为机,属本虚标实,虚瘀相夹之症。结论 对慢性关节炎的治疗,不应仅从祛风除湿散寒、补益肝肾入手,更应以祛瘀为核心,抓住疾病主要矛盾,才可标本同治。

  17. 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.

  18. 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.

  19. “治血四法”用于慢性肾病血瘀证的治疗%“Four Methods for Blood Diseases”Applied in Blood Stasis in Chronic Nephrosis

    Institute of Scientific and Technical Information of China (English)

    裘怡

    2015-01-01

    [目的]探讨慢性肾病血瘀证的治疗。[方法]通过对唐容川“治血四法”的深入研究,结合笔者的临床实践,研究“治血四法”在慢性肾病血瘀证中的应用。[结果]血瘀是慢性肾病的基本病因病机和证候之一,出血时以止血为第一要法;重视血瘀的微观辨证,消瘀活血以绝后患;针对病因,宁血防血复动;最后补血扶正以善后收功。[结论]瘀血贯穿慢性肾病始终,灵活运用“治血四法”,可达到标本同治,正本清源的目的,值得临床推广。%Objective] To discuss the treatment of blood stasis in chronic nephrosis. [Method] With deep study on Tang Rongchuang ’s“four methods for blood diseases”, by combining with author’s clinical practice, it studies the application of it in stasis of chronic nephrosis. [Result] Blood stasis is one of basic pathogenesis and syndromes;hemostasis is the first method for bleeding, paying attention to micro-differentiation of signs of stasis, avoiding the later troubles by removing stasis to activate blood circulation, pointing to the causa morbi, tranquilizing blood to prevent over-active blood, finally tonifying blood to support the essence for good result. [Conclusion] The blood stasis runs through the chronic nephrosis; to smartly apply the “four methods for blood diseases”can be the aim of the simultaneous treatment of principal and subordinate symptoms and radically reforming, worth clinical application.

  20. The bacteriology of chronic venous leg ulcer examined by culture-independent molecular methods

    DEFF Research Database (Denmark)

    Thomsen, Trine R; Aasholm, Martin S; Rudkjøbing, Vibeke B;

    2010-01-01

    , such as 16S rRNA gene sequencing, fingerprinting, quantitative polymerase chain reaction, and fluorescence in situ hybridization. Each wound contained an average of 5.4 species but the actual species varied between wounds. The diversity determined by culture-based methods and the molecular biological methods...... was different. All the wounds contained Staphylococcus aureus, whereas Pseudomonas aeruginosa was in six out of 14 wounds. Molecular methods detected anaerobic pathogens in four ulcers that were not detected with anaerobic culture methods. Quantitative polymerase chain reaction was used to compare the abundance......The bacterial microbiota plays an important role in the prolonged healing of chronic venous leg ulcers. The present study compared the bacterial diversity within ulcer material from 14 skin graft operations of chronic venous leg ulcers using culture-based methods and molecular biological methods...

  1. Chronic venous disease - Part II: Proteolytic biomarkers in wound healing.

    Science.gov (United States)

    Ligi, Daniela; Mosti, Giovanni; Croce, Lidia; Raffetto, Joseph D; Mannello, Ferdinando

    2016-10-01

    Venous leg ulcers (VLU) are characterized by sustained proteolytic microenvironment impairing the healing process. Wound fluid (WF) reflect the biomolecular activities occurring within the wound area; however, it is unclear if WF from different healing phases have different proteolytic profiles and how VLU microenvironment affects the wound healing mechanisms. We investigated the proteolytic network of WF from distinct VLU phases, and in WF- and LPS-stimulated THP-1 monocytes treated with glycosaminoglycan sulodexide, a well known therapeutic approach for VLU healing. WF were collected from patients with VLU during inflammatory (Infl) and granulating (Gran) phases. WF and THP-1 supernatants were analyzed for nine matrix metalloproteinases (MMP) and four tissue inhibitors of metalloproteinases (TIMP) by multiplex immunoassays. Our results demonstrated that: 1) WF from Infl VLU contained significantly increased concentrations of MMP-2, MMP-9, MMP-12, TIMP-1, and TIMP-2 compared to Gran WF; 2) WF from Gran VLU showed significantly increased levels of MMP-1, MMP-7, MMP-13, and TIMP-4 compared to Infl WF; 3) LPS- and WF-stimulation of THP-1 cells significantly increased the expression of several MMP compared to untreated cells; 4) Sulodexide treatment of both LPS- and WF-stimulated THP-1 significantly down-regulated the release of several MMPs. Our study provides evidence-based medicine during treatment of patients with VLU. WF from Infl and Gran VLU have different MMP and TIMP signatures, consistent with their clinical state. The modulation of proteolytic pathways in wound microenvironment by glycosaminoglycan sulodexide, provide insights for translating research into clinical practice during VLU therapy.

  2. Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.

    Science.gov (United States)

    Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

    1997-01-01

    Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion.

  3. A STUDY ON DIAMETER OF PERFORATORS AND CLINICAL SEVERITY OF CHRONIC VENOUS INSUFFICIENCY

    Directory of Open Access Journals (Sweden)

    Visakh

    2015-10-01

    Full Text Available BACKGROUND : Perforator incompetence is an important part of assessment of chronic venous insufficiency ( CVI, but the criteria for perforator incompetence and the relationship with clinical severity is not well established. AIM: To study whether measurement of diameter of perforator correlates with clinical severity of venous insufficiency. MATERIALS AND METHODS: One hundred and forty five consecutive patients ( 168 limbs with varicose veins were evaluated with Doppler study of lower limb veins. Clinical severity and diameter of perforators were assessed. RESULTS: 23% of patients with clinically mild disease had perforator diameter of 3mm or more , whereas , 62% of moderate and severe disease patients had incompetent perforator. Average diameter of perforator in CVI class 1 & 2 patients was 1.44mm whereas , in class 3 & 4 patients , it was 3.31mm and 3.58mm in class 5 & 6 patients. CONCLUSION : Diameter of perforator compare favourably with clinical severity of chronic venous insufficiency. This study may help to evolve patient management guidelines in perforator incompetence treatment

  4. Microcirculation and venous ulcers: a review.

    Science.gov (United States)

    Pascarella, Luigi; Schönbein, Geert W Schmid; Bergan, John J

    2005-11-01

    Recent histological and immunocytochemical analyses of venous leg ulcers suggest that lesions observed in the different stages of chronic venous insufficiency (CVI) may be related to an inflammatory process. This inflammatory process leads to fibrosclerotic remodeling of the skin and then to ulceration. The vascular network of the most superficial layers of the skin appears to be the target of the inflammatory reaction. Hemodynamic forces such as venous hypertension, circulatory stasis, and modified conditions of shear stress appear to play an important role in an inflammatory reaction accompanied by leukocyte activation which clinically leads to CVI: venous dermatitis and venous ulceration. The leukocyte activation is accompanied by the expression of integrins and by synthesis and release of many inflammatory molecules, including proteolytic enzymes, leukotrienes, prostaglandin, bradykinin, free oxygen radicals, cytokines, and possibly other classes of inflammatory mediators. The inflammatory reaction perpetuates itself, leading to liposclerotic skin and subcutaneous tissue remodeling. In light of the mechanisms of venous ulcer formation cited above, therapy in the future might be directed against leukocyte activation in order to diminish the magnitude of the inflammatory response. With this in mind, the attention of many investigators has been drawn to two different drugs with an anti-inflammatory effect: pentoxifylline and flavonoids.

  5. Matrix Metalloproteinases as Regulators of Vein Structure and Function: Implications in Chronic Venous Disease.

    Science.gov (United States)

    MacColl, Elisabeth; Khalil, Raouf A

    2015-12-01

    Lower-extremity veins have efficient wall structure and function and competent valves that permit upward movement of deoxygenated blood toward the heart against hydrostatic venous pressure. Matrix metalloproteinases (MMPs) play an important role in maintaining vein wall structure and function. MMPs are zinc-binding endopeptidases secreted as inactive pro-MMPs by fibroblasts, vascular smooth muscle (VSM), and leukocytes. Pro-MMPs are activated by various activators including other MMPs and proteinases. MMPs cause degradation of extracellular matrix (ECM) proteins such as collagen and elastin, and could have additional effects on the endothelium, as well as VSM cell migration, proliferation, Ca(2+) signaling, and contraction. Increased lower-extremity hydrostatic venous pressure is thought to induce hypoxia-inducible factors and other MMP inducers/activators such as extracellular matrix metalloproteinase inducer, prostanoids, chymase, and hormones, leading to increased MMP expression/activity, ECM degradation, VSM relaxation, and venous dilation. Leukocyte infiltration and inflammation of the vein wall cause further increases in MMPs, vein wall dilation, valve degradation, and different clinical stages of chronic venous disease (CVD), including varicose veins (VVs). VVs are characterized by ECM imbalance, incompetent valves, venous reflux, wall dilation, and tortuosity. VVs often show increased MMP levels, but may show no change or decreased levels, depending on the VV region (atrophic regions with little ECM versus hypertrophic regions with abundant ECM) and MMP form (inactive pro-MMP versus active MMP). Management of VVs includes compression stockings, venotonics, and surgical obliteration or removal. Because these approaches do not treat the causes of VVs, alternative methods are being developed. In addition to endogenous tissue inhibitors of MMPs, synthetic MMP inhibitors have been developed, and their effects in the treatment of VVs need to be examined.

  6. Risk factors for chronic cerebrospinal venous insufficiency (CCSVI in a large cohort of volunteers.

    Directory of Open Access Journals (Sweden)

    Kresimir Dolic

    Full Text Available BACKGROUND: The role of intra- and extra-cranial venous system impairment in the pathogenesis of various vascular, inflammatory and neurodegenerative neurological disorders, as well as in aging, has not been studied in detail. Nor have risk factors been determined for increased susceptibility of venous pathology in the intra-cranial and extra-cranial veins. The aim of this study was to investigate the association between presence of a newly proposed vascular condition called chronic cerebrospinal venous insufficiency (CCSVI and environmental factors in a large volunteer control group without known central nervous system pathology. METHODS AND FINDINGS: The data were collected in a prospective study from 252 subjects who were screened for medical history as part of the entry criteria and participated in the case-control study of CCSVI prevalence in multiple sclerosis (MS patients, and then were analyzed post-hoc. All participants underwent physical and Doppler sonography examinations, and were assessed with a structured environmental questionnaire. Fullfilment of ≥ 2 positive venous hemodynamic (VH criteria on Doppler sonography was considered indicative of CCSVI diagnosis. Risk and protective factors associated with CCSVI were analyzed using logistic regression analysis. Seventy (27.8% subjects presented with CCSVI diagnosis and 153 (60.7% presented with one or more VH criteria. The presence of heart disease (p = .001, especially heart murmurs (p = .007, a history of infectious mononucleosis (p = .002, and irritable bowel syndrome (p = .005 were associated with more frequent CCSVI diagnosis. Current or previous smoking (p = .029 showed a trend for association with more frequent CCSVI diagnosis, while use of dietary supplements (p = .018 showed a trend for association with less frequent CCSVI diagnosis. CONCLUSIONS: Risk factors for CCSVI differ from established risk factors for peripheral venous diseases. Vascular

  7. Endothelial function impairment in chronic venous insufficiency: effect of some cardiovascular protectant agents.

    Science.gov (United States)

    Carrasco, Omar F; Ranero, Alejandra; Hong, Enrique; Vidrio, Horacio

    In segments of human varicose veins, endothelial function was assessed by measuring relaxation induced by acetylcholine in noradrenaline-precontracted preparations. In addition, concentration-response curves to acetylcholine were obtained before and after incubation with the arterial endothelium protectant agents captopril, losartan, troglitazone, pravastatin, or simvastatin. The antivaricose agent escin was also tested. Mean acetylcholine-induced relaxation of varicose venous rings was about 13%, approximately one third of that reported for control saphenous veins. Concentration-response curves to acetylcholine were ''u'' shaped, the result of endothelium-mediated relaxation at low concentrations, superseded by subsequent smooth muscle contractile responses. Relaxation was enhanced by the endothelium-protecting agents and by escin, troglitazone being the least, and simvastatin the most effective. It was concluded that endothelial dysfunction is present in varicose veins, that this anomaly can be reverted by cardiovascular protecting agents, and that it can play a role in the pathogenesis and treatment of chronic venous insufficiency.

  8. Pharmacodynamics and pharmacokinetics of Veliten (rutine, alpha-tocopherol and ascorbic acid) in patients with chronic venous insufficiency.

    Science.gov (United States)

    Auteri, A; Pasqui, A L; Bruni, F; Di Renzo, M; Bova, G; Chiarion, C; Delchambre, J

    1994-01-01

    The aim of this study was to evaluate the pharmacodynamics and pharmacokinetics of a single oral dose of Veliten in 12 patients affected by chronic venous insufficiency. In particular, the pharmacokinetics of two components of Veliten, namely rutine and alpha-tocopherol, were considered, while with respect to pharmacodynamics, studies were made of venous function, haemocoagulative and fibrinolytic balance, and haemorheological parameters. Correlation between such changes and plasma drug levels was also evaluated. We found a significant increase of venous tone, venous capacity and venous distension after drug intake, as well as a significant activation of fibrinolysis (globally evaluated with euglobulin lysis time), related to a slight increase of plasminogen tissue activator. These changes appeared concomitantly with maximal plasma levels of rutine. We did not find any modifications of coagulative and haemorheological parameters.

  9. 试论慢性肺心病以瘀为本%A Discussion on the Treatment of Chronic Cor Pulmonale by Dealing with Removing Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    汤伟

    2001-01-01

    Cor pulmonale is one of intractable dis eases in clinical practice. The author considered that the pathogennic factor of the disease is a complication of phlegm, blood stasis and debility, with blood stasis as the chief pathogenesis. Its basic treatment should be activat ing blood circulation and removing blood stasis, associat ed with expelling sputum, or invigorating debility or clearing heat.%肺心病是临床常见的难治证之一。认为在肺心病痰瘀虚交互错杂的基础上,以“瘀”为最基本和最主要的病机,治疗上以活血化瘀为基础,或佐豁痰、补虚、清热等法。

  10. Extra- and transcranial echo colour Doppler in the diagnosis of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Van den Berg, P J; Visser, L H

    2012-03-01

    A new venous disorder, chronic cerebrospinal venous insufficiency (CCSVI), has been proposed in patients with multiple sclerosis (MS). It is a vascular condition characterized by an impaired cerebrospinal venous drainage due to obstructions in the main extracranial cerebrovenous outflow routes (i.e. internal jugular veins [IJV] and/or azygos veins). In this review, the studies which assessed the prevalence of CCSVI in MS by echo colour Doppler (ECD) will be discussed. The technical aspects of determination of the five CCSVI criteria: (1) reflux in the IJV and/or vertebral veins in supine and upright position, (2) reflux in the deep cerebral veins, (3) high-resolution B-mode proximal IJV stenosis, (4) flow not Doppler detectable in IJVs and/or vertebral veins (VVs) and (5) reverted postural control of the main cerebrovenous outflow pathway are described in detail. We conclude that so far there are many studies with contradictory results, and as yet a strong scientific base to support the evidence for a causative relationship of CCSVI and MS is lacking. Recent studies call into question the validity of using ECD as a proper and reliable test for the diagnosis of CCSVI. One explanation for the variety in interpretation of the individual CCSVI criteria, with the wide-ranging percentages CCSVI, could be the different methods by using ECD to determine various criteria.

  11. Is chronic HIV infection associated with venous thrombotic disease? A systematic review.

    Science.gov (United States)

    Klein, S K; Slim, E J; de Kruif, M D; Keller, T T; ten Cate, H; van Gorp, E C M; Brandjes, D P M

    2005-04-01

    Infection with the human immunodeficiency virus (HIV) is still a major health problem world-wide. HIV infection has changed into a chronic infection with the chance of developing long-term complications. Vascular complications are frequently reported in the current literature. HIV and treatment by highly active antiretroviral therapy (HAART) are associated with many cardiovascular risk factors. An increased risk of arterial cardiovascular complications was found in a number of studies. However, data about the risk of venous thrombotic disease (VTE), including potentially fatal conditions as pulmonary embolism, were limited. In a systematic review of the literature, ten relevant epidemiological studies were identified that investigated the risk of venous thrombotic disease in HIV-infected patients. The incidence was increased two- to tenfold in comparison with a healthy population of the same age. However, these studies were mainly retrospective cohort studies that were prone to selection bias, confounding factors were not always mentioned and in all but three control populations were missing. An increased risk of venous thrombotic disease in HIV-infected patients could be explained by the presence of a hypercoagulable state, characterised by an increase in procoagulant factors, such as endothelial TF expression and thrombogenic properties of microparticles, and a decrease in anticoagulant factors, including AT III, HC II and the protein C pathway. Furthermore, the risk of VTE was associated with an increased risk of infections and autoimmune haemolytic anaemia, and was weakly associated with HAART. All together, quite some evidence pointed towards a relationship between HIV infection and venous thrombotic disease, but the association still needs to be established in properly designed epidemiological studies.

  12. Bridging the gap between chronic cerebrospinal venous insufficiency and Ménière disease

    Directory of Open Access Journals (Sweden)

    Dario C. Alpini

    2016-07-01

    Full Text Available Ménière disease (MD is a chronic illness of the inner ear that affects a substantial number of patients every year worldwide. Because of a dearth of well-controlled studies, the medical and surgical management of MD remains quite empirical. The main reason is that it is very difficult to investigate patients affected with Certain MD due to the post-mortem criterion necessary for this diagnostic grade. Although endolymphatic hydrops (EH is the worldwideaccepted mechanism of MD, the causes that induce it are still not clear. In fact MD has been correlated mostly to a wide and different disturbances ranging from trauma to sleep disorders. It is nowadays sufficiently demonstrated that chronic cerebrospinal venous insufficiency (CCSVI is very frequent in MD. Even if CCSVI may potentially induce EH through a pure hydraulic mechanism CCSVI, per se does not explain how the various disorders correlated with MD may interact with CCSVI and provoke EH. The aim of this review is an attempt to approach MD into the context of the more recent findings about the global brain waste clearance system, to which inner ear is anatomically and functionally connected, in order to build a reasonable model of MD pathogenesis. The major part of the diseases correlated to MD may act on the inner ear disturbing the glymphatic (GS and/or brain lymphatic system (BLS activity. The venous system interplays with GS and BLS. In this model CCSVI is considered more than a direct cause of MD rather the anatomical predisposition to develop the disease. In this model EH, and then MD, is the consequence of a failure of the compensation of the congenital venous abnormalities, anatomical compensation as collateral pathways and/or functional compensation as GS and BLS. In this model the major part of the disturbances correlated to MD and the various treatment proposed find their appropriate placement.

  13. Extracellular matrix assessment of infected chronic venous leg ulcers: role of metalloproteinases and inflammatory cytokines.

    Science.gov (United States)

    Serra, Raffaele; Grande, Raffaele; Buffone, Gianluca; Molinari, Vincenzo; Perri, Paolo; Perri, Aldina; Amato, Bruno; Colosimo, Manuela; de Franciscis, Stefano

    2016-02-01

    Chronic venous ulcer (CVU) represents a dreaded complication of chronic venous disease (CVD). The onset of infection may further delay the already precarious healing process in such lesions. Some evidences have shown that matrix metalloproteinases (MMPs) are involved and play a central role in both CVUs and infectious diseases. Two groups of patients were enrolled to evaluate the expression of MMPs in infected ulcers and the levels of inflammatory cytokines as well as their prevalence. Group I comprised 63 patients (36 females and 27 males with a median age of 68·7 years) with infected CVUs, and group II (control group) comprised 66 patients (38 females and 28 males with a median age of 61·2 years) with non-infected venous ulcers. MMP evaluation and dosage of inflammatory cytokines in plasma and wound fluid was performed by means of enzyme-linked immunosorbent assay test; protein extraction and immunoblot analysis were performed on biopsied wounds. The first three most common agents involved in CVUs were Staphylococcus aureus (38·09%), Corynebacterium striatum (19·05%) and Pseudomonas aeruginosa (12·7%). In this study, we documented overall higher levels of MMP-1 and MMP-8 in patients with infected ulcers compared to those with uninfected ulcers that showed higher levels of MMP-2 and MMP-9. We also documented higher levels of interleukin (IL)-1, IL-6, IL-8, vascular endothelial growth factor and tumour necrosis factor-alpha in patients with infected ulcers with respect to those with uninfected ulcers, documenting a possible association between infection, MMP activation, cytokine secretions and symptoms. The present results could represent the basis for further studies on drug use that mimic the action of tissue inhibitors of metalloproteinases in order to make infected CVU more manageable.

  14. 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 clini......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......'s effect on the peri-ulcer area. Blood samples were analysed for silver content. RESULTS: Twenty-three out of 25 patients completed the study. One ulcer healed and no wound infections occurred during the study period. A mean 56% reduction in ulcer area (from 15.6 to 6.9 cm2) was recorded during the four...... weeks, and there was a mean 25% reduction in granulation tissue from dull to healthy after one week. Wound odour reduced significantly after one week. Mean dressing wear time was 3.1 days, and there were only minimal incidences of leakage. Serum silver levels did not exceed reference values. CONCLUSION...

  15. The use of central venous lines in the treatment of chronically ill children.

    Science.gov (United States)

    Barczykowska, Ewa; Szwed-Kolińska, Marzena; Wróbel-Bania, Agnieszka; Ślusarz, Robert

    2014-01-01

    Treatment of chronic diseases in children is a special medical problem. Maintaining constant access to the central vascular system is necessary for long-term hemato-oncological and nephrological therapies as well as parenteral nutrition. Providing such access enables chemotherapic treatment, complete parenteral nutrition, long-term antibiotic therapy, hemodialysis, treatment of intensive care unit patients, monitoring blood pressure in the pulmonary artery and stimulation of heart rate in emergency situations as well as treatment of patients suffering from complications, especially when chances of access into peripheral veins are exhausted. Continuous access to the central vascular system is desirable in the treatment of chronically ill children. Insertion of a central venous catheter line eliminates the unnecessary pain and stress to a child patient accompanying injection into peripheral vessels. In order to gain long-term and secure access to the central venous system, respecting the guidelines of the Center for Disease Control and Prevention contained in the updated 'Guidelines for the Prevention of Intravascular Catheter-Related Infections' is necessary.

  16. 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

  17. 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

  18. 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).

  19. Chronic cerebrospinal venous insufficiency in multiple sclerosis: clinical correlates from a multicentre study

    Directory of Open Access Journals (Sweden)

    Bastianello Stefano

    2011-10-01

    Full Text Available Abstract Background Chronic cerebrospinal venous insufficiency (CCSVI has recently been reported to be associated with multiple sclerosis (MS. However, its actual prevalence, possible association with specific MS phenotypes, and potential pathophysiological role are debated. Method We analysed the clinical data of 710 MS patients attending six centres (five Italian and one Canadian. All were submitted to venous Doppler sonography and diagnosed as having or not having CCSVI according to the criteria of Zamboni et al. Results Overall, CCSVI was diagnosed in 86% of the patients, but the frequency varied greatly between the centres. Even greater differences were found when considering singly the five diagnostic criteria proposed by Zamboni et al. Despite these differences, significant associations with clinical data were found, the most striking being age at disease onset (about five years greater in CCSVI-positive patients and clinical severity (mean EDSS score about one point higher in CCSVI-positive patients. Patients with progressive MS were more likely to have CCSVI than those with relapsing-remitting MS. Conclusion The methods for diagnosing CCSVI need to be refined, as the between-centre differences, particularly in single criteria, were excessively high. Despite these discrepancies, the strong associations between CCSVI and MS phenotype suggest that the presence of CCSVI may favour a later development of MS in patients with a lower susceptibility to autoimmune diseases and may increase its severity.

  20. Association of Mild to Moderate Chronic Kidney Disease With Venous Thromboembolism Pooled Analysis of Five Prospective General Population Cohorts

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Gansevoort, Ron T.; Naess, Inger Anne; Lutsey, Pamela L.; Braekkan, Sigrid K.; Veeger, Nic J. G. M.; Brodin, Ellen E.; Meijer, Karina; Sang, Yingying; Matsushita, Kunihiro; Hallan, Stein I.; Hammerstrom, Jens; Cannegieter, Suzanne C.; Astor, Brad C.; Coresh, Josef; Folsom, Aaron R.; Hansen, John-Bjarne; Cushman, Mary

    2012-01-01

    Background-Recent findings suggest that chronic kidney disease (CKD) may be associated with an increased risk of venous thromboembolism (VTE). Given the high prevalence of mild-to-moderate CKD in the general population, in depth analysis of this association is warranted. Methods and Results-We poole

  1. Internet-based social networking and its role in the evolution of chronic cerebrospinal venous insufficiency.

    Science.gov (United States)

    Vera, Chido; Herr, Allen; Mandato, Kenneth; Englander, Meridith; Ginsburg, Lauren; Siskin, Gary P

    2012-06-01

    The Internet is being seen as a growing resource for health-related information for a large number of patients. It is undeniable that its widespread presence has led to the growth of awareness that chronic cerebrospinal venous insufficiency (CCSVI) as an entity that may contribute to the symptoms experienced by patients with multiple sclerosis (MS). Social networking and file-sharing Web sites have brought patients with MS together from all over the world and have facilitated the distribution of personal experiences and information derived from medical research as it relates to CCSVI. As a result, there has been an accelerated growth in the number of patients seeking treatment for this syndrome in light of the possibility that it may improve their present condition. This article will review this phenomenon, the Internet-based resources available to MS patients seeking information about CCSVI, and the responsibilities of physicians as they participate in these online discussions.

  2. Repair of Chronic Achilles Ruptures Has a High Incidence of Venous Thromboembolism.

    Science.gov (United States)

    Bullock, Mark J; DeCarbo, William T; Hofbauer, Mark H; Thun, Joshua D

    2016-11-23

    Background Despite the low incidence of deep vein thrombosis (DVT) in foot and ankle surgery, some authors report a high incidence of symptomatic DVT following Achilles tendon rupture. The purpose of this study was to identify DVT risk factors inherent to Achilles tendon repair to determine which patients may benefit from prophylaxis. Methods One hundred and thirteen patient charts were reviewed following elective and nonelective Achilles tendon repair. For elective repair of insertional or noninsertional Achilles tendinopathy, parameters examined included lateral versus prone positioning and the presence versus absence of a flexor hallucis longus transfer. For nonelective repair, acute Achilles tendon ruptures were compared to chronic Achilles tendon ruptures. Results Of 113 Achilles tendon repairs, 3 venous thromboembolism (VTE) events (2.65%) occurred including 2 pulmonary emboli (1.77%). Seventeen of these repairs were chronic Achilles tendon ruptures, and all 3 VTE events (17.6%) occurred within this subgroup. Elevated body mass index was associated with VTE in patients with chronic Achilles ruptures although this did not reach significance (P = .064). No VTE events were reported after repair of 28 acute tendon ruptures or after 68 elective repairs of tendinopathy. Two patients with misdiagnosed partial Achilles tendon tears were excluded because they experienced a VTE event 3 weeks and 5 weeks after injury, prior to surgery. Conclusion In our retrospective review, chronic Achilles ruptures had a statistically significant higher incidence of VTE compared with acute Achilles ruptures (P = .048) or elective repair (P = .0069). Pharmaceutical anticoagulation may be considered for repair of chronic ruptures. Repair of acute ruptures and elective repair may not warrant routine prophylaxis due to a lower incidence of VTE.

  3. 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.

  4. Cardiac tamponade arising from a venous source following anterograde dissection re-entry coronary angioplasty to a chronic total occlusion.

    Science.gov (United States)

    Danson, E; Arena, F; Sapontis, J; Ward, M; Bhindi, R

    2016-10-01

    Cardiac tamponade is a rare complication of coronary intervention to chronic total occlusions (CTO PCI). We report a case of persistent bleeding from a venous source following successful anterograde dissection-reentry (ADR) CTO PCI. Pericardiocentesis was performed 1 h post-procedure for tamponade. Persistent bleeding was investigated with contrast transesophageal echocardiography, pericardial manometry and blood analysis. Coronary venography revealed subtle extravasation from a cardiac vein adjacent to the site of luminal re-entry. Coronary venous perforation using ADR CTO PCI has not previously been described; however, the volume of blood loss may be significant and surgical exploration may be appropriate.

  5. Stasis Theory and Paleontology Discourse

    Science.gov (United States)

    Northcut, Kathryn M.

    2007-01-01

    Stasis theory is a powerful tool for rhetorical analysis, recently under fresh consideration by rhetorical theorists (e.g. Gross) and scholars who identify its utility in the writing classroom (e.g. Carroll). In this study, the author applies stasis theory to a paleontological argument involving a controversial fossil, "Protoavis texensis."…

  6. Prevalence of deep venous thrombosis in patients with acute exacerbation of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    DUAN Sheng-chen; YANG Yuan-hua; LI Xu-yan; LIANG Xiao-ning; GUO Rui-jun; XIE Wan-mu; KUANG Tu-guang; DAI Hua-ping; WANG Chen

    2010-01-01

    Background Acute exacerbation of chronic obstructive pulmonary disease (COPD) is always associated with a high incidence and mortality. Because of the presence of some concomitant risk factors such as immobilization, bronchial superinfection, patients who are admitted for acute exacerbations of COPD are generally considered to be at moderate risk for the development of venous thromboembolism. In this study, we investigated the prevalence and the clinical manifestations of deep venous thrombosis (DVT) in patients with acute exacerbation of COPD.Methods From March 2007 to March 2009, 520 consecutive patients were included in this study. On admission, color Doppler ultrasound of lower extremities in all cases was performed for diagnosing DVT. Patients with DVT were compared with those without DVT from such aspects as demographics, symptoms, physical signs and risk factors.Results Among the 520 patients, DVT was found in 46 cases (9.7%). In patients with DVT, the duration of hospitalization was longer (P=0.01), and the mechanical ventilation requirement increased (P <0.001). Other indicators for patients with more possibility of DVT were immobility exceeding 3 days (P <0.001); pneumonia as concomitance (P=0.01); respiratory failure type Ⅱ (P=0.013); current smoking (P=0.001). Lower extremity pain was more common in DVT cases in comparison to those without DVT (34.8% vs. 15.2%, P=0.01 ).Conclusions The acute exacerbation of COPD patients, who were immobilized for over 3 days, complicated by pneumonia and had respiratory failure type Ⅱ, had a higher risk of DVT. In addition, DVT detection awareness should be increased in cases that had a lower extremity pain.

  7. O-(beta-hydroxyethyl)-rutosides systemic and local treatment in chronic venous disease and microangiopathy: an independent prospective comparative study.

    Science.gov (United States)

    Belcaro, Gianni; Rosaria Cesarone, Maria; Ledda, Andrea; Cacchio, Marisa; Ruffini, Irma; Ricci, Andrea; Ippolito, Edmondo; Di Renzo, Andrea; Dugall, Mark; Corsi, Marcello; Marino Santarelli, Anna Rita; Grossi, Maria Giovanna

    2008-01-01

    O-(beta-hydroxyethyl)-rutosides (HR) is used to treat chronic venous disease and signs and symptoms of chronic venous insufficiency (CVI), varicose veins, and deep venous disease. This independent prospective controlled trial (a registry study) evaluates how the efficacy of HR at the local level (perimalleolar region) can be increased by the administration of a topical HR gel. The study is based on evaluation of microcirculatory variables in patients with severe CVI (ambulatory venous pressure, > 56 mm Hg) and venous microangiopathy. Patients are treated using 1 of the following 3 regimens: oral treatment with 1 g sachets of HR (2 g/d total) plus topical HR 2% gel applied 3 times daily at the internal perimalleolar region; oral treatment only (same dosage), or light elastic compression stockings. Laser Doppler skin flux at rest, skin flux at the perimalleolar region, and transcutaneous PO2 and PCO2 are measured at baseline and at the end of the treatment period. A comparable group of healthy individuals without treatment is observed for 8 weeks. In the treatment groups, flux is increased, PO2 is decreased, and PCO2 is increased compared with normal skin. At 4 and 8 weeks, the improvement in skin flux (which is decreased by all measurements), the increase in PO2, and the decrease in PCO2 (indicating microcirculatory improvement) are statistically significantly greater in the combined oral plus topical treatment group (P < .05). No adverse effects, tolerability problems, or compliance issues are noted. These results indicate an important role of HR in the treatment and control of CVI and venous microangiopathy.

  8. 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....... 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...... area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. RESULTS: Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings...

  9. 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.

  10. Chronic Complications After Femoral Central Venous Catheter-related Thrombosis in Critically Ill Children.

    Science.gov (United States)

    Sol, Jeanine J; Knoester, Hennie; de Neef, Marjorie; Smets, Anne M J B; Betlem, Aukje; van Ommen, C Heleen

    2015-08-01

    Prescription of thromboprophylaxis is not a common practice in pediatric intensive care units. Most thrombi are catheter-related and asymptomatic, without causing acute complications. However, chronic complications of these (a)symptomatic catheter-related thrombi, that is, postthrombotic syndrome (PTS) and residual thrombosis have not been studied. To investigate these complications, critically ill children of 1 tertiary center with percutaneous inserted femoral central venous catheters (FCVCs) were prospectively followed. Symptomatic FCVC-thrombosis occurred in 10 of the 134 children (7.5%; 95% confidence interval [CI], 2.4-9.5). Only FCVC-infection appeared to be independently associated (P=0.001) with FCVC-thrombosis. At follow-up 2 of the 5 survivors diagnosed with symptomatic thrombosis developed mild PTS; one of them had an occluded vein on ultrasonography. A survivor without PTS had a partial occluded vein at follow-up. Asymptomatic FCVC-thrombosis occurred in 3 of the 42 children (7.1%; 95% CI, 0.0-16.7) screened by ultrasonography within 72 hours after catheter removal. At follow-up, mild PTS was present in 6 of the 33 (18.2%; 95% CI, 6.1-30.3) screened children. Partial and total vein occlusion was present in 1 (3%) and 4 (12%) children, respectively. In conclusion, children on pediatric intensive care units are at risk for (a)symptomatic FCVC-thrombosis, especially children with FCVC-infection. Chronic complications of FCVC-thrombosis are common. Therefore, thromboprophylaxis guidelines are warranted in pediatric intensive care units to minimize morbidity as a result of FCVC-thrombosis.

  11. Venous thrombosis: an overview

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, C.W.

    1986-07-01

    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, /sup 125/I-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.

  12. Percutaneous transluminal angioplasty in a patient with chronic cerebrospinal venous insufficiency and persistent left superior vena cava.

    Science.gov (United States)

    Lupattelli, T; Benassi, F; Righi, E; Bavera, P; Bellagamba, G

    2014-04-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome characterized by stenoses of the internal jugular veins (IJVs) and/or azygos veins and formation of collateral venous channels. A case of a 57-year-old patient with CCSVI in whom the venous outflow from the left IJV to the right atrium occurred through a venous anomaly, the persistent left superior vena cava (PLSVC), is reported. PLSVC is caused by persistence of the left anterior cardinal vein that drains blood from the limb effluent from the left and the left side of head and neck into coronary sinus (Type a), or in the left atrium (Type b). PLSVC can be associated either with innominate vein hypoplasia or other congenital heart abnormalities. Because of evidence of left innominate vein hypoplasia, angioplasty was not performed using the ordinary route but passing with the balloon directly through the PLSVC up to the left IJV. Finally, angioplasty was carried out in a standard manner in the right IJV as well as in the azygous vein. Confirmation angiogram revealed complete reopening of all treated vessels with no evidence of peri- and postoperative complications. The patient was discharged home the following day in good general conditions. PLSVC is a rare congenital vein anomaly but in case of concomitant innominate vein hypoplasia may prove to be a valuable alternative to treat patients with IJV diseases.

  13. GM-CSF Exhibits Anti-Inflammatory Activity on Endothelial Cells Derived from Chronic Venous Disease Patients

    Directory of Open Access Journals (Sweden)

    Veronica Tisato

    2013-01-01

    Full Text Available Twenty patients affected by chronic venous disease (CVD in tertiary venous network and/or saphenous vein were analyzed before surgical ablation by echo-color-doppler for the hemodynamic parameters reflux time (RT and resistance index (RI, a negative and a positive prognostic factor, respectively. RT and RI were next correlated with relevant in vitro parameters of venous endothelial cells (VEC obtained from surgical specimens, such as cell migration in response to serum gradient, proliferation index, intercellular adhesion molecule (ICAM-1 and vascular cell adhesion molecule (VCAM-1 expression, as well as cytokines release. Of interest, ICAM-1 expression in patient-derived VEC cultures correlated positively with RT and negatively with RI. Moreover, RT showed a positive correlation with the baseline osteoprotegerin (OPG expression by VEC and an inverse correlation with VEC proliferation index. On the other hand, RI correlated positively with TNF-related apoptosis inducing ligand (TRAIL expression. Among the cytokines released by VEC, GM-CSF showed a positive correlation with VEC proliferation and TRAIL expression and a negative correlation with OPG, ICAM-1 and VCAM-1 expression. Since in vitro recombinant GM-CSF induced VEC proliferation and counteracted the induction of ICAM-1, VCAM-1 and OPG upon exposure to TNF-α, our data suggest an anti-inflammatory activity of GM-CSF on venous endothelial cells.

  14. Factors affecting patients’ self-management in chronic venous disorders: a single-center study

    Directory of Open Access Journals (Sweden)

    Barański K

    2016-08-01

    Full Text Available Kamil Barański,1,2 Jerzy Chudek2,3 1Department of Epidemiology, Medical School in Katowice, 2Department of Pathophysiology, Medical University of Silesia, Katowice, 3Angiology Outpatient Clinic “Combi-Med,” Częstochowa, Poland Background: The conservative treatment of chronic venous disorders (CVDs includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors. Objective: The aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management. Methods: A structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23–87 years. All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP classification. Results: Pharmacotherapy was the most frequently (85.0% of respondents used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99–3.05] and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16–2.62] were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08–3.03]. Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61–3.88] and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35–26.4]. Longer duration of CVD (≥15 years increased (OR =1.78 [95% CI 1.16–2.71] while obesity decreased (OR =0.38 [95% CI 0.20–0.72] the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97–2.90]. Physiotherapy was rarely

  15. PredyCLU: a prediction system for chronic leg ulcers based on fuzzy logic; part I - exploring the venous side.

    Science.gov (United States)

    de Franciscis, Stefano; Fregola, Salvatore; Gallo, Alessandro; Argirò, Giuseppe; Barbetta, Andrea; Buffone, Gianluca; Caliò, Francesco G; De Caridi, Giovanni; Amato, Bruno; Serra, Raffaele

    2016-12-01

    Chronic leg ulcers (CLUs) are a common occurrence in the western population and are associated with a negative impact on the quality of life of patients. They also cause a substantial burden on the health budget. The pathogenesis of leg ulceration is quite heterogeneous, and chronic venous ulceration (CVU) is the most common manifestation representing the main complication of chronic venous disease (CVD). Prevention strategies and early identification of the risk represent the best form of management. Fuzzy logic is a flexible mathematical system that has proved to be a powerful tool for decision-making systems and pattern classification systems in medicine. In this study, we have elaborated a computerised prediction system for chronic leg ulcers (PredyCLU) based on fuzzy logic, which was retrospectively applied on a multicentre population of 77 patients with CVD. This evaluation system produced reliable risk score patterns and served effectively as a stratification risk tool in patients with CVD who were at the risk of developing CVUs.

  16. [The possible uses of balneotherapy in treating chronic venous insufficiency of lower limbs].

    Science.gov (United States)

    Petraccia, L; Mennuni, G; Fontana, M; Nocchi, S; Libri, F; Conte, S; Alhadeff, A; Romano, B; Messini, F; Grassi, M; Fraioli, A

    2013-01-01

    The Chronic Venous Insufficiency (CVI) of inferior limbs is a widespread disease, with an increasing incidence as a consequence of longer life expectance, life-style, obesity, smoking, use of drugs as oestrogens and progestins and working conditions. Medical therapy is still lacking for evidence of efficacy, and compression therapy is useful only in preventing a worsening of this condition. Surgical treatment is the only radical therapy effective for the advanced phases of the disease. In this context spa balneotherapy can be considered as a possible chance to improve some subjective and objective symptoms of CVI of inferior limbs, and to prevent worsening of this condition. The authors performed a review of the relevant scientific literature concerning the treatment of CVI of inferior limbs with mineral water balneotherapy, in order to evaluate its effects on objective and subjective symptoms and its effectiveness to prevent further worsening. We searched the PubMed/Medline, Cochrane Library, Embase, Web of Science databases for articles published between 1990 and 2011 on this topic. To this end, the authors selected few clinical-controlled and case-controlled studies; patients affected from CVI of inferior limbs were treated with balneotherapy at health spas with sulphureous, sulphate, salsojodic or salsobromojodic mineral waters. Baths in mineral waters were often associated with idromassotherapy and vascular pathway. Effects of spa balneotherapy are related to some aspecific properties, like hydrostatic pressure, osmotic pressure and water temperature, partly related with specific chemico-physical properties of the adopted mineral water. The controlled clinical studies on spa therapy showed significant improvement of subjective (such as itch, paresthesias, pain, heaviness) and objective symptoms (namely edema and skin discromias). These studies suggest that spa balneotherapy may give a good chance of secondary prevention and effective therapy of CVI of inferior

  17. Improvement of signs and symptoms of chronic venous insufficiency and microangiopathy with Pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Ippolito, E; Fano, F; Dugall, M; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2010-09-01

    The aim of this study was to evaluate the clinical efficacy of standardized French maritime pine bark extract Pycnogenol in patients with severe chronic venous insufficiency (CVI). 98 subjects with symptomatic CVI and edema were randomly assigned to one group treated with 150 mg Pycnogenol a day only, another group with stockings only and a third group with both Pycnogenol and elastic stockings. The average ambulatory venous pressure (AVP) at inclusion was 58+/-7 mm Hg (range 48-60 mm Hg) with a refilling time (RT)Pycnogenol alone was more effective than compression alone for all parameters (pPycnogenol in the management, treatment and control of CVI also in combination with compression.

  18. Ms HU Ling-xiang's Experience in Treating Blood Stasis by Acupuncture Balancing Method

    Institute of Scientific and Technical Information of China (English)

    FU Jia; LI Ji; ZHANG Cai-rong

    2005-01-01

    @@ HU Ling-xiang, 60, is a chief doctor and supervisor of postgraduates of master degree. She specializes in the syndrome differentiation and treatment of different kinds of chronic and difficult disorders from the perspective of blood stasis theory.

  19. Evidence for a genetic role in varicose veins and chronic venous insufficiency.

    Science.gov (United States)

    Krysa, J; Jones, G T; van Rij, A M

    2012-10-01

    There is a strong body of circumstantial evidence which implicates genetics in the aetiology and pathology of varicose veins and venous ulcer disease. The aim of this review is to consider the current knowledge of the genetic associations and the ways in which new genetic technologies may be applied to advancing our understanding of the cause and progression of these venous diseases. A number of publications have used a candidate gene approach to identify genes implicated in venous disease. Although these studies have opened up important new insights, there has been a general failure to replicate results in an independent cohort of patients. With our limited knowledge of the biological pathways involved in the pathogenesis of venous disease we are not in a strong position to formulate truly erudite a priori candidate gene hypothesis-directed studies. A genome-wide association study should therefore be considered to help further our understanding of the genetic basis of venous disease. Due to the large sample sizes required for discovery and validation, using the new generations of molecular technologies, it will be necessary to form collaborating groups in order to successfully advance the field of venous disease genetics.

  20. Clinical Study on Chronic Gastritis Treated by Methods of Replenishing qi,Activating Spleen and Eliminating Blood Stasis%益气健脾化瘀法治疗慢性胃炎临床研究

    Institute of Scientific and Technical Information of China (English)

    刘俊峰; 何高潮

    2012-01-01

    目的:探讨益气健脾化瘀法治疗慢性胃炎的疗效.方法:将90例患者随机分为两组.治疗组60例采用益气健脾化瘀法治疗,药用丹参、檀香、砂仁、党参、白术、茯苓、枳壳、厚朴、黄连、吴茱萸、百合、乌药、甘草治疗.对照组30例采用法莫替丁片合果胶铋胶囊治疗.结果:治疗组痊愈28例,显效12例,有效17例,无效3例,有效率95.00%;对照组痊愈8例,显效11例,有效6例,无效5例,有效率83.00%;两组有效率比较差异有显著性意义(P<0.05),治疗组疗效优于对照组.结论:益气健脾化瘀法治疗慢性胃炎疗效满意.%Objective:To discuss the therapeutic effects of the method of replenishing qi, activating spleen and eliminating blood stasis on the treatment of chronic gastritis. Methods:90 cases were randomly divided into two groups. The treatment group(60 cases) was treated by methods of replenishing qi,activating spleen and eliminating blood stasis,and the Chinese herbs were Danshen( Radix Salvia Miltior-rhiza) ,Tanxiang(Sandalwood) ,Sharen( Fructus amomi) ,Dangshen(Codonopsis pilosula) , Baizhu( White Atractylodes Rhizome) , Ful-ing(Poria) ,Zhiqiao(Fructus aurantii immaturus ) , Houpo ( Mangnolia officinalis ), Huanglian ( Goldthread ), Wuzhuyu ( Fructus evodi-ae) ,Baihe(Lily) ,Wuyao( Radix Linderae) , Gancao(liquorice). The control group(30 cases) was treated by Famotidine Tablets and Colloidal Bismuth Pectin Capsules. Results:In the treatment group,28 cases were cured, 12 achieved excellent effects, 18 were effective, 3 were ineffective and the effective rate was 95% ;in the control group,8 cases were cured, 11 achieved excellent effects,6 were effective,5 were ineffective and the effective rate was 83%. Comparison of the total effective rates between two groups showed that the difference had notable significance(P <0.05) ,and the curative effects of the treatment group was superior to the control group. Conclusion: The methods of

  1. 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...

  2. Bilateral surgical reconstruction for internal jugular veins disease in patients with chronic cerebrospinal venous insufficiency and associated multiple sclerosis.

    Science.gov (United States)

    Spagnolo, Salvatore; Scalise, Filippo; Barbato, Luciano; Grasso, Maria Antonietta; Tesler, Ugo F

    2014-10-01

    Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by morphologic alterations involving efferent cerebral vascular paths. CCSVI has been implicated as a contributing factor to multiple sclerosis (MS) but this theory is highly controversial. We report 3 cases of CCSVI patients with MS who had undergone internal jugular veins (IJVs) angioplasty to restore vessels patency. All patients reported significant symptomatic improvement after angioplasty until symptoms recurred after restenosis of the treated IJVs. Surgical IJVs reconstruction was performed. Patients' symptoms gradually improved and the benefits were maintained at the 1-year follow-up.

  3. Adverse events after endovascular treatment of chronic cerebro-spinal venous insufficiency (CCSVI) in patients with multiple sclerosis.

    Science.gov (United States)

    Ghezzi, A; Annovazzi, P; Amato, M P; Capello, E; Cavalla, P; Cocco, E; Falcini, M; Gallo, A; Patti, F; Perini, P; Rodegher, M E; Rovaris, M; Rottoli, M R; Comi, G

    2013-06-01

    Although it is debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients undergo endovascular treatment (ET) of CCSVI. A study is ongoing in Italy to evaluate the clinical outcome of ET. Severe adverse events (AEs) occurred in 15/462 subjects at a variable interval after ET: jugular thrombosis in seven patients, tetraventricular hydrocephalus, stroke, paroxysmal atrial fibrillation, status epilepticus, aspiration pneumonia, hypertension with tachicardia, or bleeding of bedsore in the remaining seven cases. One patient died because of myocardial infarction 10 weeks after ET. The risk of severe AEs related to ET for CCSVI must be carefully considered.

  4. Phase 3 evaluation of HP802-247 in the treatment of chronic venous leg ulcers.

    Science.gov (United States)

    Kirsner, Robert S; Vanscheidt, Wolfgang; Keast, David H; Lantis, John C; Dove, Cyaandi R; Cazzell, Shawn M; Vartivarian, Mher; Augustin, Matthias; Marston, William A; McCoy Bs, Nicholas D; Cargill PhD, D Innes; Lee Mshs, Tommy D; Dickerson, Jaime E; Slade Md, Herbert B

    2016-09-01

    In 2012 we reported promising results from a phase 2 clinical trial of HP802-247, a novel spray-applied investigational treatment for chronic venous leg ulcers consisting of human, allogeneic fibroblasts and keratinocytes. We now describe phase 3 clinical testing of HP802-247, its failure to detect efficacy, and subsequent investigation into the root causes of the failure. Two randomized, controlled trials enrolled a total of 673 adult outpatients at 96 centers in North America and Europe. The primary endpoint was the proportion of ulcers with confirmed closure at the end of 12 weeks of treatment. An investigation into the root cause for the failure of HP802-247 to show efficacy in these two phase 3 trials was initiated immediately following the initial review of the North American trial results. Four hundred twenty-one patients were enrolled in the North American (HP802-247, 211; Vehicle 210) and 252 in the European (HP802-247, 131; Vehicle 121) trials. No difference in proportion of closed ulcers at week 12 was observed between treatment groups for either the North American (HP802-247, 61.1%; Vehicle 60.0%; p = 0.5896) or the European (HP802-247, 47.0%; Vehicle 50.0%; p = 0.5348) trials. Thorough investigation found no likelihood that design or execution of the trials contributed to the failure. Variability over time during the trials in the clinical response implicated the quality of the cells comprising HP802-247. Concordance between the two separate, randomized, controlled trials with distinct, nonoverlapping investigative sites and independent monitoring teams renders the possibility of a Type II error vanishingly small and provides strong credibility for the unexpected lack of efficacy observed. The most likely causative factors for the efficacy failure in phase 3 was phenotypic change in the cells (primarily keratinocytes) leading to batch to batch variability due to the age of the cell banks.

  5. Immune function of erythrocytes in patients with chronic venous insufficiency of the lower extremities

    Institute of Scientific and Technical Information of China (English)

    ZHANG Lan; ZHANG Bai-gen; ZHANG Ji-wei; ZHANG Hao

    2007-01-01

    Background The influence of inflammatory processes has been one of the hot topics in discussions of the etiology of chronic venous insufficiency(CVI).Erythrocytes are very important in controlling inflammatory immunity and innate immune reactions.The purpose of this study was to analyze the correlation between the development of CVI and the change of CD35,Fy6 on erythrocytes,and interleukin-8(IL-8) levels.Methods A group of 43 patients with CVI were studied in parallel with 8 healthy individuals serving as centrol subjects.Control subjects were those with normal findings on lower extremity duplex examinations.We used an erythrocyte flow cytometer to examine the expression of both CD35 and Fy6 on red blood cells,and an enzyme-linked immunosorbent assay analysis method to measure plasma IL-8 levels.We also analyzed the change of IL-8 levels under the influence of erythrocytes using a modified method of the hemaimmune reaction.Results Compared with normal centrol subjects,CD35 expression increased significantly among patients with CVI classified as C4 without lipodermatosclerosis,but tended to decrease and reach the lowest level among patients classified as C5-C6.Fy6 expression increased significantly among patients in the early stages of CVI,but tended to decrease remarkably among patients classified as C5-C6.The inflammatory response intensified at the C5-C6 classification,where high levels of IL-8 coexisted with a low expression of Fy6.The increase in IL-8 in the CVI group was higher than in the control group in association with the complete blood cells,regardless of the presence of erythrocytes,when inactive tumour cells were added,whereas the level of IL-8 in the CVI group was significantly lower than in the control group.Conclusions Abnormalities of erythrocyte innate immunity represents a fundamental derangement in CVI.These inadequate inflammatory responses may lead to local tissue and microvascular damage of the lower extremity.

  6. Venous Sampling

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Venous sampling Venous sampling is a diagnostic procedure that uses ... the limitations of venous sampling? What is venous sampling? Venous sampling is a diagnostic procedure that involves ...

  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. Femoral and iliofemoral thrombectomy to prevent chronic venous insufficiency. Follow-up of 18 patients.

    Science.gov (United States)

    de Araujo Bessa, J C

    1986-01-01

    Eighteen patients with femoral and iliofemoral venous thrombosis were treated surgically. Five of the patients had a moderate degree of venous congestion and were classified as having phlegmasia alba dolens and 13 patients had phlegmasia cerulea dolens. The mean age was 39 years, range 18-60 years; 6 were men and 12 women. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. In all cases the thrombosis was verified by phlebography. Pre- and postoperative phlebography was used in all cases to show the patency of the femoral and iliofemoral segment. There was no operative pulmonary embolism or mortality. Heparin infusion was continued in the thrombectomized segment for 10 days followed by phenprocumone treatment. The patients were followed from 6 to 8 months, postoperatively. The operation was performed in the acute stage and the late results are as follows: 4 limbs good, 6 limbs fair and 8 limbs poor. The best results were obtained when the latency period was 24 to 72 hours. Postthrombotic sequelae could not be prevented in about 44% of all patients despite venous thrombectomy.

  9. Pathogenesis of chronic venous insufficiency and possible effects of compression and pentoxifylline.

    Science.gov (United States)

    Coleridge Smith, P D

    1993-01-01

    It has been recognized for over 2000 years that ulceration of the leg may be associated with visible varices of the lower limb. More recent physiological investigation has shown that the pressure in the veins of the lower limb remains raised in patients with venous ulceration during ambulation, whereas in normal subjects the pressure in superficial veins falls to a low level. This elevated pressure appears to cause damage to the superficial capillaries in the skin culminating in the production of venous ulceration. Events in the dermal capillaries which result in skin destruction have yet to be fully defined. Pericapillary fibrin cuffs have been demonstrated histologically and suggested as a cause of diminished nutrition to the skin. White blood cells have been shown to accumulate in the lower limb of patients with venous disease and these accumulations are particularly located around the dermal capillaries. Activated white blood cells releasing free radicals and destructive enzymes may precipitate skin destruction. An understanding of these mechanisms may help to explain the efficacy of compression hosiery and bandaging as well as some of the new pharmacological agents which have been shown to influence venous ulcer healing.

  10. May symptoms of chronic cerebrospinal venous insufficiency be improved by venous angioplasty? An independent 4-year follow up on 366 cases

    Directory of Open Access Journals (Sweden)

    Pietro M. Bavera

    2015-10-01

    Full Text Available The aim of the study was to collect results from 366 chronic cerebrospinal venous insufficiency (CCSVI affected patients that were regularly Duplex controlled after having received vein angioplasty following diagnosis for CCSVI. The procedures were all performed in the same Centre and same equipment. The patients were divided into three groups according to the attributed severity of the associated multiple sclerosis: 264 relapse-remitting (RR (72%: 179 females (67.8% and 85 (32.2% males; 62 secondary progressive (17%: 37 (59.7% females and 25 (40.3% males; 40 primary progressive (11%: 22 (55% females and 18 (45% males. A data base revealed eleven most frequent disturbs and symptoms, together with working capacities, and was kept up-todate at every Duplex control aiming to establish a novel rapid CCSVI symptoms questionnaire assessment in 4 years follow up. The symptoms were: diplopia, fatigue, headache, upper limb numbness/mobility, lower limb numbness/mobility, thermic sensibility, bladder control, balance coordination, quality of sleep, vertigo, mind concentration. Results, as follows, appear to be significantly good in the RR group, also the biggest one. Diplopia improved in 262/264 patients (99.2% (P<0.0001; fatigue in 260/264 (98.5% (P<0.0001; headache in 205/208 (98.6% (P<0.0001; balance coordination in 23/26 (88.5% (P<0.0001; quality of sleep in 55/59 (93.2% (P<0.0001; vertigo in 30/33 (90.9% (P<0.0001; mind concentration in 142/144 (98.6% (P<0.0001. Other results regarded: upper limb numbness and mobility in 20/24 (83.3% (P=0.0002; lower limb numbness and mobility 13/15 (86.7% (P=0.0087; thermic sensibility 3/4 (75% [P: not significant (n.s.]; bladder control 2/3 (66.6% (P: n.s.. In contrast in the progressive cases results are quite different where, nevertheless, some useful considerations were collected and statistically significant, too. In addition, venous angioplasty appears to be safe, side effects were observed only in seven

  11. Is vein damage the only cause of clinical signs of lower limb chronic venous insufficiency?

    Directory of Open Access Journals (Sweden)

    Amélia Cristina Seidel

    2014-09-01

    Full Text Available Background:Venous insufficiency is a very prevalent disease. Some decades ago a group of patients was identified that had symptoms of venous insufficiency, but no visible anatomic abnormalities. Studies showed that this subset had reduced venous tone, and their condition became known as hypotonic phlebopathy.Objective:To investigate prevalence, age group and variations in body mass index (BMI among patients with hypotonic phlebopathy.Methodology:A total of 1,960 limbs were examined in 1,017 patients who had been referred for complaints compatible with venous insufficiency. Patients with BMI ≥ 30 were defined as obese. The patients were examined using color Doppler ultrasonography to detect presence or absence of reflux in veins of the lower limbs and were then distributed into two groups as follows: patients with CEAP ≤ 1 and no reflux, diagnosed with hypotonic phlebopathy; or patients with CEAP ≥ 2 and reflux.Results:The study sample comprised 89.7% women and 10.3% men with a mean age of 44.9 years. Hypotonic phlebopathy was more common among the women (p = 0.0001. Obese women were more likely than women who were not obese to have venous symptom etiology involving trunk lesions (p = 0.0017. Among the men, obesity was unrelated to etiology of symptoms (p = 0.5991. Symptomology was more likely to be related to trunk vein damage among older age groups than among younger age groups (p-valor <0.0001.Conclusions:Hypotonic phlebopathy was very prevalent, particularly among young women who were not obese.

  12. Novel treatment techniques for recanalization of femoral-popliteal deep venous occlusion from chronic thrombosis.

    Science.gov (United States)

    Spencer, Elizabeth Brooke; Stratil, Peter; Mizones, Heidi

    2014-06-01

    Patients with postthrombotic syndrome due to previous femoral-popliteal deep venous thrombosis often experience lifestyle-limiting lower-extremity pain and swelling. Conservative treatment options include compression stockings and lymphedema massage, but in many cases these treatments only temporarily and partially improve symptoms. Ultrasound and venography in patients with postthrombotic syndrome often show only partial recanalization of the femoral vein with significant collateral vein formation. These abnormal veins are insufficient for adequate venous drainage from the lower extremity as evidenced by the patient's continued symptoms. Recanalization of the occluded or partially occluded femoral vein using prolonged venoplasty, with or without chemical thrombolysis, combined with optimizing anticoagulation and conservative treatment measures, results in lasting improvement in symptoms for a high percentage of patients.

  13. Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães

    Directory of Open Access Journals (Sweden)

    Antônio Roberto de Barros Coelho

    2000-06-01

    Full Text Available Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2, base deficit (BD and oxygen tension (PO2 in portal, caval and systemic arterial blood, as well as for increments of BD (DBD in portal and caval blood. With a confidence level of 95%, the results showed that: 1. There were not changes of pH anDBD in portal and systemic arterial blood in the majority of studied times; 2. There was metabolic acidosis in caval blood; 3. The negative increments of BD (DBD were higher in caval blood than in splancnic venous blood at T10, T30 and T105; and, 4. Deoxigenation of portal and caval blood were detected. Acid-base metabolism and oxigenation monitoring of subdiaphramatic venous blood can constitute an effective way to evaluate experimental passive portal-jugular and caval-jugular bypass in dogs.A descompressão venosa subdiafragmática durante a fase anhepática do transplante ortotópico de fígado em cães atenua a estase de sangue nas veias Porta e Cava Inferior e minimiza a hipoperfusão tissular e a acidose metabólica observadas na oclusão dessas veias. Durante duashoras, seis cães submetidos a desvios porta-jugular e cava-jugular passivos, com permanência do fluxo arterial hepático, foram avaliados através de pH, PCO2, DB e PO2 no sangue portal, da Veia Cava Inferior e arterial sistêmico, bem como por incrementos de DB (DDB no sangue portal e da Veia Cava Inferior. Os resultados obtidos permitem concluir com uma confiança de 95% que: 1. Não foram constatadas alterações de pH e DB no sangue portal e arterial sistêmico na maioria dos tempos estudados; 2. Houve acidose

  14. Treating 52 cases of gynecological chronic pelvic pain (qi stagnation and blood stasis type) by herbal penetration therapy%中药外治法治疗妇科慢性盆腔痛(气滞血瘀型)52例

    Institute of Scientific and Technical Information of China (English)

    陈琰; 王赛莉; 赵燕宁

    2012-01-01

      Objective: To observe the clinical curative effects of herbal enema and herbal penetration therapy in treating gynecological chronic pelvic pains and investigate the mechanism of relieving pains. Methods: 52 cases of patients with gynecological chronic pelvic pains were selected and treated with herbal enema and herbal penetration therapy. The variation of pain scores before and after treatment was observed to evaluate the improvement of chronic pelvic pains by herbal enema and herbal penetration therapy, while the TCM syndromes scores and Hamilton depression scores (24 items) were observed to evaluate the improvement of TCM syndromes of chronic pelvic pain and the affection of depressed emotion by herbal enema and herbal penetration therapy. Results: Syndromes of chronic pelvic pain improved obviously after treatment. The total effective rate was 88.46%. There was a significant difference between the pain scores before and after treatment (P<0.01). The depressed emotion of patients improved a lot along with the relieving of pains. There was a significant difference between the Hamilton depressed scores before and after treatment (P<0.01). Conclusion: The herbal enema and herbal penetration therapy had an obvious effect in dispersing the depressed liver-energy, promoting Qi, warming meridians, activating blood circulation, removing blood stasis and pains. It was worthy of wide application because it could relieve the syndromes of chronic pelvic pain and improve the depressed emotion of patients, and in addition it was convenient, effective and with little side effects.%  目的:观察中药灌肠、中药外敷治疗气滞血瘀型妇科慢性盆腔痛的临床疗效,探讨其缓解疼痛的作用机理.方法:选择妇科慢性盆腔痛(气滞血瘀型)患者52例,予中药保留灌肠、中药外敷治疗两个疗程,通过观察治疗前后数字疼痛评分(NRS)的变化,评价中药灌肠、外敷对妇科慢性盆腔疼痛的改善情

  15. 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.

  16. 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.

  17. [Phlebosclerosing therapy after operative intervention for chronic venous insufficiency of the lower extremities].

    Science.gov (United States)

    Shamsadinskiĭ, A A; Shamsadinskaia, T A

    2009-02-01

    To the Center of angiology and microsurgery have been submitted 75 patients seeking for the cosmetic result of their treatment improvement, to whom operative interventions for the lower extremities varicosities were performed previously. The sclerosing procedures for the dilated venous tributaries, reticular veins and teleangiectasiae was conducted, complete elimination of a "heavy feet" syndrome was noted together with reduction of the symptoms severity. The phlebosclerosing method permits to achieve good clinical, aesthetic results, to improve the quality of life and social activity of the patients.

  18. Recommendations for multimodal noninvasive and invasive screening for detection of extracranial venous abnormalities indicative of chronic cerebrospinal venous insufficiency: a position statement of the International Society for Neurovascular Disease.

    Science.gov (United States)

    Zivadinov, Robert; Bastianello, Stefano; Dake, Michael D; Ferral, Hector; Haacke, E Mark; Haskal, Ziv J; Hubbard, David; Liasis, Nikolaos; Mandato, Kenneth; Sclafani, Salvatore; Siddiqui, Adnan H; Simka, Marian; Zamboni, Paolo

    2014-11-01

    Under the auspices of the International Society for Neurovascular Disease (ISNVD), four expert panel committees were created from the ISNVD membership between 2011 and 2012 to determine and standardize noninvasive and invasive imaging protocols for detection of extracranial venous abnormalities indicative of chronic cerebrospinal venous insufficiency (CCSVI). The committees created working groups on color Doppler ultrasound (US), magnetic resonance (MR) imaging, catheter venography (CV), and intravascular US. Each group organized a workshop focused on its assigned imaging modality. Non-ISNVD members from other societies were invited to contribute to the various workshops. More than 60 neurology, radiology, vascular surgery, and interventional radiology experts participated in these workshops and contributed to the development of standardized noninvasive and invasive imaging protocols for the detection of extracranial venous abnormalities indicative of CCSVI. This ISNVD position statement presents the MR imaging and intravascular US protocols for the first time and describes refined color Doppler US and CV protocols. It also emphasizes the need for the use of for noninvasive and invasive multimodal imaging to diagnose adequately and monitor extracranial venous abnormalities indicative of CCSVI for open-label or double-blinded, randomized, controlled studies.

  19. Prevention of venous thromboembolism in hospitalized patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Marcora Mandreoli

    2013-04-01

    Full Text Available Despite the high morbidity and mortality associated with venous thromboembolism in hospitalized medical patients with a number of risk factors, and large evidence that prophylaxis is effective, prophylaxis rates remain elusive in medically ill patients. Furthermore, in patients with renal failure, prophylaxis often is omitted or sub-optimal, due to fear of provoking hemorrhage. Patients with end-stage renal disease often have platelet deficits. Low molecular weight heparin (LMWH therapy may also be difficult to manage in these cases because LMWH clearance is largely dependent on the kidneys. Administration of LMWH to patients with some degree of renal failure may lead to bioaccumulation of anti-Xa activity with an increased risk of bleeding. In recent years, LMWH has largely replaced unfractionated heparin (UFH for the treatment and prophylaxis of thromboembolic disease. LMWHs have been shown to be superior to UFH in the prevention of venous thromboembolism. They are also easier to administer and do not require laboratory monitoring. However, several case reports and a metaanalysis indicate that the use of LMWHs at therapeutic doses in patients with advanced renal failure can be associated with major bleeding with serious adverse effects. In this paper, we review recent evidence supporting the safety of LMWHs at prophylactic doses in patients with mild or moderate renal disease. Current evidence suggests that bioaccumulation of enoxaparin (the most widely used LMWH can occur when the drug is used at standard therapeutic doses in patients with severely impaired renal function. This risk can be reduced by empiric dose reduction or monitoring of anti-Xa heparin levels.

  20. 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.

  1. Forkhead box C2 promoter variant c.-512C>T is associated with increased susceptibility to chronic venous diseases.

    Directory of Open Access Journals (Sweden)

    Sumi Surendran

    Full Text Available Chronic venous disease (CVD is one of the most prevalent yet underrated disorders worldwide. High heritability estimates of CVD indicate prominent genetic components in its etiology and pathology. Mutations in human forkhead box C2 (FoxC2 gene are strongly associated with valve failure in saphenous and deep veins of lower extremities. We explored the association of genetic variants of FoxC2 as well as FoxC2 mRNA and protein expression levels with CVD of lower limbs. We systematically sequenced the single coding exon, 5' and 3' flanking regions of FoxC2 gene in 754 study subjects which includes 382 patients with CVD and 372 healthy subjects. Four novel and three reported polymorphisms were identified in our cohort. Three variants in 5' flanking region and one in 3' flanking region of FoxC2 gene were significantly associated with CVD risk. FoxC2 mRNA in vein tissues from 22 patients was 4±1.42 fold increased compared to saphenous veins from 20 normal subjects (pT (rs34221221: C>T variant which is located in the FoxC2 putative promoter region was further analyzed. Functional analysis of c.-512C>T revealed increased mRNA and protein expression in patients with homozygous TT genotype compared to heterozygous CT and wild CC genotypes. Luciferase assay indicated higher transcriptional activity of mutant compared to wild genotype of this variant. These findings suggested that c.-512C>T variant of FoxC2 was strongly associated with susceptibility to CVD and also that this variant resulted in FoxC2 overexpression. To obtain a mechanistic insight into the role of upregulated FoxC2 in varicosities, we overexpressed FoxC2 in venous endothelial cells and observed elevated expression of arterial markers Dll4 and Hey2 and downregulation of venous marker COUP-TFII. Our study indicates altered FoxC2-Notch signaling in saphenous vein wall remodeling in patients with varicose veins.

  2. Observer agreement of lower limb venous reflux assessed by duplex ultrasound scanning using manual and pneumatic cuff compression in patients with chronic venous disease and controls

    DEFF Research Database (Denmark)

    Broholm, R; Kreiner, S; Bækgaard, Niels;

    2011-01-01

    The study aimed to evaluate observer agreement between two experienced ultrasound operators examining deep venous reflux assessed by duplex ultrasound (DU) using either manual or pneumatic cuff compression. In addition, the two methods were compared with each other with regard to immediate...

  3. Symptoms in patients with skin changes due to chronic venous insufficiency often lead to emergency care service: an Italian observational study.

    Science.gov (United States)

    Ruggiero, Michele; Grande, Raffaele; Naso, Agostino; Butrico, Lucia; Rubino, Paolo; Placida, Girolamo Domenico; Cannistrà, Marco; Serra, Raffaele

    2016-10-01

    Chronic venous insufficiency (CVI) is the most advanced form of chronic venous disease (CVD), and is often associated with skin changes such as hyperpigmentation, eczema, lipodermatosclerosis and venous skin ulceration that cause discomfort, pain, sleep disturbances, absenteeism in the workplace, disability and deteriorated quality of life (QoL). The purpose of this study is to evaluate the prevalence of CVI and skin changes in patients who turn to Continuous Assistance Services due to the presence of disturbing symptoms of their condition. Data were evaluated by consulting the medical records, during a 16-month period, available with three Continuous Assistance Services of the Italian territory. The overall population of the referring centres consisted of 1186 patients [739 females (62·31%) and 447 males (37·69%)]. Seventy-nine patients (6·66%) consulted the emergency unit for venous symptoms related to CVD. Patients with more severe disease (CVI, categories C4-C6) represented the majority accounting for 60·75%, while patients with moderate disease (C3) accounted for 35·44% and patients with mild disease (C1-C2 stages) accounted for 3·79%. The main finding of this study is that despite CVI not being a disease that commonly requires medical emergency/urgency intervention, patients with CVI, especially in advanced stage with skin changes, may turn to Continuous Assistance Service for treating bothersome symptoms related to their condition.

  4. Diagnostic performance of magnetic resonance venography in the detection of recanalization in patients with chronic cerebral venous sinus thrombus

    Institute of Scientific and Technical Information of China (English)

    SUN Ying; ZHENG Dong-you; JI Xun-ming; Peter WEALE; WU Hao; JIANG Li-dan; YANG Li-zhuang

    2009-01-01

    Background In the chronic stage of cerebral venous sinus thrombosis (CVST), recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography (MRV) in the evaluation of the recanalization of CVST.Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight (2D-TOF) MRV in thirty-two consecutive patients during a three- to six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography (DSA) were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard.Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% (62/68), 93% (37/40), 95% (62/65), and 86% (37/43) respectively.Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.

  5. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    Nyuk Jet Chong

    2013-01-01

    Full Text Available We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI. We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.

  6. Chronic hypoxia increases TRPC6 expression and basal intracellular Ca2+ concentration in rat distal pulmonary venous smooth muscle.

    Directory of Open Access Journals (Sweden)

    Lei Xu

    Full Text Available Hypoxia causes remodeling and contractile responses in both pulmonary artery (PA and pulmonary vein (PV. Here we explore the effect of hypoxia on PV and pulmonary venous smooth muscle cells (PVSMCs.Chronic hypoxic pulmonary hypertension (CHPH model was established by exposing rats to 10% O2 for 21 days. Rat distal PVSMCs were isolated and cultured for in vitro experiments. The fura-2 based fluorescence calcium imaging was used to measure the basal intracellular Ca2+ concentration ([Ca2+]i and store-operated Ca2+ entry (SOCE. Quantitative RT-PCR and western blotting were performed to measure the expression of mRNA and levels of canonical transient receptor potential (TRPC protein respectively.Hypoxia increased the basal [Ca2+]i and SOCE in both freshly dissociated and serum cultured distal PVSMCs. Moreover, hypoxia increased TRPC6 expression at mRNA and protein levels in both cultured PVSMCs exposed to prolonged hypoxia (4% O2, 60 h and distal PV isolated from CHPH rats. Hypoxia also enhanced proliferation and migration of rat distal PVSMCs.Hypoxia induces elevation of SOCE in distal PVSMCs, leading to enhancement of basal [Ca2+]i in PVSMCs. This enhancement is potentially correlated with the increased expression of TRPC6. Hypoxia triggered intracellular calcium contributes to promoted proliferation and migration of PVSMCs.

  7. Central venous line complications with chronic ambulatory infusion of prostacyclin analogues in pediatric patients with pulmonary arterial hypertension.

    Science.gov (United States)

    Marr, Courtney R; McSweeney, Julia E; Mullen, Mary P; Kulik, Thomas J

    2015-06-01

    Chronic infusion of prostacyclin (PGI2) via a Broviac central venous line (CVL) is attended by risk of CVL-related complications, but we know of only one report regarding CVL-associated bloodstream infection (BSI) with PGI2 in children and none regarding other complications. We conducted a retrospective cohort study involving pediatric patients with pulmonary hypertension treated with chronic intravenous infusion of PGI2 at Boston Children's Hospital and determined the rate (per 1,000 line-days) of various CVL-related complications. We also determined how often complications necessitated line replacement and hospitalization, time to replacement of CVLs, and interpatient variability in the incidence of complications. From 1999 until 2014, 26 patients meeting follow-up criteria had PGI2 infusion, representing 43,855 line-days; mean follow-up was 56 months (range, 1.4-161 months). The CVL complication rates (per 1,000 line-days) were as follows: CVL-BSI, 0.25; superficial line infection, 0.48; impaired integrity, 0.59; occlusion, 0.09; and malposition, 0.32. The total complication rate was 1.73 cases per 1,000 line-days. All CVL-BSI and malposition cases were treated with CVL removal and replacement. Of CVLs with impaired integrity, 23 could be repaired and 3 required replacement. Six of 21 superficial CVL infections required replacement of the CVL. Three of 4 occluded CVLs were replaced. CVL complications occasioned 65 hospitalizations. There was marked interpatient variability in the rate of complications, much but not all of which appeared to be related to duration of CVL placement. We conclude that non-BSI complications are very significant and that efforts to teach and emphasize other aspects of line care are therefore very important.

  8. 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

    Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been les...... chronic wounds have approached or even reached the end of their lifespan (phase III). This might provide one explanation for the non-healing state and therapy resistance to topical platelet-derived growth factor-BB of some venous leg ulcers.......Several pathophysiologic mechanisms have been proposed to explain slow-healing leg ulcers, but little is known about the growth behavior of cells in these wounds. Platelet-derived growth factor-BB applied topically to chronic wounds has shown beneficial effects, although the effects have been less...... 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...

  9. '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.)

  10. 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.

  11. Drug therapy of chronic venous insufficiency of the lower limbs%下肢慢性静脉功能不全的药物治疗

    Institute of Scientific and Technical Information of China (English)

    王深明; 姚陈

    2011-01-01

    Chronic venous insufficiency (CVI) of the lower limbs is a kind of vascular disease with high morbidity. The etiological factors of CVI are venous hypertension and inflammation cascade reaction.The mechanisms are thepharmacological targets of most drugs for CVI. Systemic drugtherapy has been tried for many years in an attempt to reducesymptoms and improve microcirculation. The first aim of drugtherapy is to improve CVI symptoms and avoid adversereaction.%下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是常见的血管外科疾病.病因主要有下肢静脉血流异常所导致的静脉高压以及静脉压升高后导致静脉系统出现的炎症级联反应.目前治疗CVI的药物多是以上述发病机制为靶点,在缓解症状、改善微循环方面具有重要作用.有效改善下肢慢性静脉疾病的症状并且尽量避免不良反应的出现是药物治疗的首要目标.

  12. 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。

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Giovanna Figueiredo

    Full Text Available 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.Twenty-three mice underwent catheterization of the jugular vein and subcutaneous implantation of a VAMP. The VAMP was flushed every second day with 50 μL of heparinized saline solution (25 IU/ml. DSA was performed during injection of 100 μL of an iodine based contrast agent using an industrial X-ray inspection system intraoperatively, as well as 7±2 and 14±2 days post implantation.DSA allowed localization of catheter tip position, to rule out dislocation, kinking or occlusion of a microcatheter, and to evaluate parent vessel patency. In addition, we observed different ante- and retrograde collateral flow patterns in case of jugular vein occlusion. More exactly, 30% of animals showed parent vessel occlusion after 7±2 days in our setting. At this time point, nevertheless, all VAMPs verified intravascular contrast administration. After 14±2 days, intravascular contrast injection was verified in 70% of the implanted VAMPs, whereas at this point of time 5 animals had died or were sacrificed and in 2 mice parent vessel occlusion hampered intravascular contrast injection. Notably, no occlusion of the catheter itself was observed.From our observations we conclude DSA to be a fast and valuable minimally invasive tool for investigation of catheter and parent vessel patency and for anatomical studies of collateral blood flow in animals as small as mice.

  15. 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.

  16. 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.

  17. 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.

  18. Hypoperfusion of brain parenchyma is associated with the severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a cross-sectional preliminary report

    Directory of Open Access Journals (Sweden)

    Bergsland Niels

    2011-03-01

    Full Text Available Abstract Background Several studies have reported hypoperfusion of the brain parenchyma in multiple sclerosis (MS patients. We hypothesized a possible relationship between abnormal perfusion in MS and hampered venous outflow at the extracranial level, a condition possibly associated with MS and known as chronic cerebrospinal venous insufficiency (CCSVI. Methods We investigated the relationship between CCSVI and cerebral perfusion in 16 CCSVI MS patients and 8 age- and sex-matched healthy controls. Subjects were scanned in a 3-T scanner using dynamic susceptibility, contrast-enhanced, perfusion-weighted imaging. Cerebral blood flow (CBF, cerebral blood volume (CBV and mean transit time (MTT were measured in the gray matter (GM, white matter (WM and the subcortical GM (SGM. The severity of CCSVI was assessed according to the venous hemodynamic insufficiency severity score (VHISS on the basis of the number of venous segments exhibiting flow abnormalities. Results There was a significant association between increased VHISS and decreased CBF in the majority of examined regions of the brain parenchyma in MS patients. The most robust correlations were observed for GM and WM (r = -0.70 to -0.71, P P corrected = 0.022, and for the putamen, thalamus, pulvinar nucleus of thalamus, globus pallidus and hippocampus (r = -0.59 to -0.71, P P corrected Conclusions This pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons.

  19. Chronic Venous Insufficiency

    Science.gov (United States)

    ... restlessness, tiredness, fatigue, pain, throbbing, burning, itching and muscle cramping. In advanced cases, breakdown of the skin may cause bleeding from varicose veins, and large varicosities may develop blood clots, a condition ... muscles may improve calf muscle function T he V ...

  20. Diagnosis and treatment of venous ulcers.

    Science.gov (United States)

    Collins, Lauren; Seraj, Samina

    2010-04-15

    Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet aggregation, and intracellular edema. The primary risk factors for venous ulcer development are older age, obesity, previous leg injuries, deep venous thrombosis, and phlebitis. On physical examination, venous ulcers are generally irregular, shallow, and located over bony prominences. Granulation tissue and fibrin are typically present in the ulcer base. Associated findings include lower extremity varicosities, edema, venous dermatitis, and lipodermatosclerosis. Venous ulcers are usually recurrent, and an open ulcer can persist for weeks to many years. Severe complications include cellulitis, osteomyelitis, and malignant change. Poor prognostic factors include large ulcer size and prolonged duration. Evidence-based treatment options for venous ulcers include leg elevation, compression therapy, dressings, pentoxifylline, and aspirin therapy. Surgical management may be considered for ulcers that are large in size, of prolonged duration, or refractory to conservative measures.

  1. 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.……

  2. 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.

  3. Using the MEM-net program to report on mapping the EchoColorDoppler assessment for chronic cerebro spinal venous insufficiency

    Directory of Open Access Journals (Sweden)

    Mandolesi S

    2014-07-01

    Full Text Available Sandro Mandolesi,1 Aldo d’Alessandro,2 Ettore Manconi,3 Tarcisio Niglio,4 Augusto Orsini,5 Dimitri Mandolesi,6 Alessandro d'Alessandro,7 Francesco Fedele1 1Department of Cardiovascular and Respiratory Sciences, Sapienza University Rome, Rome, Italy; 2Department of Angiology, “T Masselli-Mascia” Hospital, San Severo (FG, Foggia, Italy; 3Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy; 4Istituto Superiore di Sanità, Rome, Italy; 5Department of Vascular Surgery, “Gioia” Hospital, Sora (FR, Sora, Italy; 6Medicina del lavoro Sapienza University Roma, Rome, Italy; 7Faculty of Medicine, Catholic University “Our Lady of Good Counsel,” Tirana, Albania Introduction: Chronic cerebrospinal venous insufficiency (CCSVI is characterized by multiple stenosis/obstructions affecting the principal extracranial outflow pathways of the cerebrospinal venous system. Using EchoColorDoppler (ECD to assess chronic CCSVI is a very difficult and long examination. It takes about an hour even for an expert sonographer. Methods: Hemodynamic morphological map (MEM-Net is a program that works on the Internet. All the morphological and hemodynamic data of the patient can be entered into the program’s anatomical scheme to create a map of the ECD report. The program also allows us to collect all the data during the ECD assessment and, using its algorithm, make the report uniform. Conclusion: Reporting on the map by using MEM-net shortens the time of ECD written reporting that is done automatically. The program also makes a blind control of the report and enables the use of it for scientific research. We hope that in the future everyone will use this data collection tool for all scientific work on this topic. Keywords: CCSVI, ECD, Map, cerebral venous system, sonography

  4. 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.

  5. Evaluating safety of tunneled small bore central venous catheters in chronic kidney disease population: A quality improvement initiative.

    Science.gov (United States)

    Bhutani, Gauri; El Ters, Mireille; Kremers, Walter K; Klunder, Joe L; Taler, Sandra J; Williams, Amy W; Stockland, Andrew H; Hogan, Marie C

    2016-09-20

    Introduction Peripherally inserted central venous catheters (PICCs) may adversely impact future successful arteriovenous fistulae (AVF). As part of a quality improvement project, the performance of tunneled small bore tunneled central venous catheters (TSB-CVCs), as alternatives to PICCs, was evaluated. Methods A retrospective observational study, involving individuals ≥18 years of age who underwent TSB-CVC placement by Interventional Radiology at Mayo Clinic, Rochester, MN between 1/1/2010 and 8/30/2013. Findings The study cohort included 92 patients with a median age of 55 (46-67) years, who underwent 108 TSB-CVC placements. Baseline renal disease was present in 71% (77/108). Most TSB-CVCs were placed in hospitalized patients (94%; 102/108); five French in diameter (61%; 66/108) and located in an internal jugular vein (84%; 91/108). Median catheter indwelling time was 20 (11-43) days (n = 84). TSB-CVC-related bloodstream infection, deep venous thrombosis (DVT), and superficial venous thrombosis (SpVT) rates per line were 0.009 (1/108), 0.018 (2/108), and 0.009 (1/108), respectively. Venous outcomes in a subgroup of 54 patients, who had documented PICC placements (n = 161) in addition to TSB-CVC (n = 58) were compared. TSB-CVC-DVT rate was lower than the PICC-DVT rate (0.017 [1/58] vs. 0.106 per line [17/161]; P = 0.04). The TSB-CVC-SpVT rate was not different from the PICC-SpVT rate (0 [0/58] vs. 0.037 [6/161] per line; P = 0.14). Discussion TSB-CVCs demonstrated an excellent safety profile in our study. These catheters should be preferentially utilized for arm vein preservation in advanced kidney disease. Their impact on future AVF success needs further evaluation.

  6. 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.

  7. The aetiology of deep venous thrombosis.

    Science.gov (United States)

    Malone, P C; Agutter, P S

    2006-09-01

    Most ideas about the pathogenesis of deep venous thrombosis (DVT) are dominated by a 'consensus model' first articulated around 1962. This model invokes 'Virchow's triad' and attributes thrombogenesis in veins to some combination of 'hypercoagulability', 'stasis' and 'intimal injury'. This arose as a by-product of studies on the mechanisms of haemostasis and bleeding diatheses that were at best only indirectly relevant to thrombosis, and there are reasons for doubting the causal significance of 'hypercoagulability' and 'stasis' in the aetiology of DVT. Proponents of the consensus model make little reference to a substantial literature, mostly historical, that: (a) emphasizes the significance of the venous valve pockets (VVP) and blood rheology in DVT pathogenesis; and (b) describes morphological features specific to venous thrombi that a valid aetiological model must explain. This literature provides the basis for an alternative hypothesis of DVT aetiology, published some 30 years ago, which has been experimentally corroborated and is compatible with recent cell and molecular biological studies of the venous endothelium. We review this alternative hypothesis, considering its potential value for future research on DVT and embolism, and its significance for clinical practice.

  8. Determination of Oxidative Stress in Patients With Chronic Venous Ulcer%慢性静脉性溃疡组织中氧化应激产物的测定

    Institute of Scientific and Technical Information of China (English)

    杨帆; 邓璐

    2016-01-01

    ABSTRACT:ObjectiveTo clarify whether there is oxidative stress in chronic venous ulcer, and to lay a theoretical foundation for the further study of the pathogenesis of chronic venous ulcer. Methods 36 cases were diagnosed from January 2015 to October 2015 were treated for chronic venous insufficiency of lower extremity ulcers in patients with ulcer specimens, determination of malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) content and compared with the burn ulcer tissue and normal skin tissue.Results With the control group (normal skin, burn ulcer group),duration of ulcer2 weeks and> 1 month group, venous ulceration of the concentration of MDA significantly increased (P2weeks and >1 month group, the SOD、GSH of venous ulcer group significantly reduced (P2周和>1月组,静脉性溃疡MDA浓度显著增加(P2周和>1月组中,静脉性溃疡组SOD、GSH明显减少(P<0.05)。结论静脉性溃疡创面氧化应激反应增强,抗氧化能力减弱,并产生了大量的氧化应激产物。

  9. The impact of obesity on venous insufficiency.

    Science.gov (United States)

    Seidel, A C; Belczak, C E Q; Campos, M B; Campos, R B; Harada, D S

    2015-08-01

    Association between chronic venous disease and obesity has recently been studied, with indications that it may worsen in obese patients. The aim of study was to correlate clinical classes of chronic venous disease according to Clinical Etiology Anatomy Pathophysiology (CEAP) classification and body mass index, as well as to compare the severity of chronic venous disease in obese and nonobese patients. This retrospective cross-sectional prevalence study was conducted at the Maringá State University and Belczak Vascular Center along a period of 2 years, consisting of a random sample of 482 patients with complaints compatible with chronic venous disease. Data obtained from patient's files included gender, age, weight and height (for calculating body mass index), and clinical class (C) of chronic venous disease according to CEAP classification. Statistical analysis included Spearman's correlation coefficient, Chi-square test (for comparing frequencies), and Student's t-test (for comparing means). Significant positive correlation between body mass index and clinical classes was established for women (0.43), but not for men (0.07). Obesity (body mass index  : ≥  : 30.0) was significantly more frequent in patients with chronic venous disease in clinical classes 3 (p venous disease in clinical class 1 (p venous disease in women, but not in men. It also corroborated the negative impact of obesity on the clinical severity of chronic venous disease.

  10. Endovascular treatment of chronic cerebro spinal venous insufficiency in patients with multiple sclerosis modifies circulating markers of endothelial dysfunction and coagulation activation: a prospective study.

    Science.gov (United States)

    Napolitano, Mariasanta; Bruno, Aldo; Mastrangelo, Diego; De Vizia, Marcella; Bernardo, Benedetto; Rosa, Buonagura; De Lucia, Domenico

    2014-10-01

    We performed a monocentric observational prospective study to evaluate coagulation activation and endothelial dysfunction parameters in patients with multiple sclerosis undergoing endovascular treatment for cerebro-spinal-venous insufficiency. Between February 2011 and July 2012, 144 endovascular procedures in 110 patients with multiple sclerosis and chronical cerebro-spinal venous insufficiency were performed and they were prospectively analyzed. Each patient was included in the study according to previously published criteria, assessed by the investigators before enrollment. Endothelial dysfunction and coagulation activation parameters were determined before the procedure and during follow-up at 1, 3, 6, 9, 12, 15 and 18 months after treatment, respectively. After the endovascular procedure, patients were treated with standard therapies, with the addition of mesoglycan. Fifty-five percent of patients experienced a favorable outcome of multiple sclerosis within 1 month after treatment, 25% regressed in the following 3 months, 24.9% did not experience any benefit. In only 0.1% patients, acute recurrence was observed and it was treated with high-dose immunosuppressive therapy. No major complications were observed. Coagulation activation and endothelial dysfunction parameters were shown to be reduced at 1 month and stable up to 12-month follow-up, and they were furthermore associated with a good clinical outcome. Endovascular procedures performed by a qualified staff are well tolerated; they can be associated with other currently adopted treatments. Correlations between inflammation, coagulation activation and neurodegenerative disorders are here supported by the observed variations in plasma levels of markers of coagulation activation and endothelial dysfunction.

  11. [Use of laser technologies in treatment of chronic venous insufficiency in patients with a wide ostial segment of the main trunks of subcutaneous veins].

    Science.gov (United States)

    Luk'ianenko, M Iu; Starodubtsev, V B; Karpenko, A A; Sergeevichev, D S

    2014-01-01

    Presented herein is the authors' experience in endovascular laser obliteration of the major trunks of the grate saphenous vein (GSV) with a wide ostial segment (measuring from 15 to 34 mm) in patients presenting with chronic venous insufficiency. Group One patients (n=32) underwent crossectomy followed by endovasal laser obliteration (EVLO) of the GSV's trunk on the femur. Group Two patients (n=46) were not subjected to crossectomy, whereas obliteration of the GSV's trunk was carried out immediately from the ostium. In Group One we managed to achieve obliteration of the GSV's trunk in 32 patients (100%) with no additional interventions, and in Group Two this was achieved in 42 (91.3%) patients. Four patients (8.7%) required performing a secondary procedure of EVLO after which obliteration of the trunk was achieved in all patients of Group Two. There was no evidence of deep-vein thrombosis.

  12. 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.

  13. Etiology and pathogensis of chronic venous ulcer of lower extremities%下肢静脉性溃疡相关病因及其发生机制的研究

    Institute of Scientific and Technical Information of China (English)

    查斌山; 朱化刚

    2010-01-01

    Venous leg ulceration is a common, debilitating chronic condition, which is the most severe complications of chronic venous insufficiency. The persistent venous hypertension is the primary cause of ve-nous ulcer, and leukocyte activation plays a key role in the formation of venous ulcers,and other related fac-tors such as heart disease also play an important role in the development of varicose to ulceration.%慢性静脉性溃疡是下肢慢性静脉功能不全中最严重的最难治的并发症.持续性的静脉高压是引起静脉性溃疡的主要原因;白细胞激活在静脉性溃疡的形成中起关键作用;心脏病等相关因素在静脉曲张向溃疡发展的过程中亦发挥着重要作用.

  14. 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.

  15. 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.

  16. Venous Ultrasound (Extremities)

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound - Venous (Extremities) Venous ultrasound uses sound waves to ... limitations of Venous Ultrasound Imaging? What is Venous Ultrasound Imaging? Ultrasound is safe and painless, and produces ...

  17. The vegetal biomembrane in the healing of chronic venous ulcers Biomembrana vegetal na cicatrização de úlceras venosas crônicas

    Directory of Open Access Journals (Sweden)

    Marco Andrey Cipriani Frade

    2012-02-01

    Full Text Available BACKGROUND: The vegetal biomembrane has been used to treat cutaneous ulcers. OBJECTIVES: To assess the role of the vegetal biomembrane on the chronic venous ulcers treatment compared to treatment with collagenase cream. METHODS: Fourteen patients were selected to be treated with vegetal biomembrane and 7 with Fibrase®(CONTROL, followed clinically and photographically by the Wound Healing Index by ImageJ during 120 days and biopsied on the 1st and 30th days for histological examination. RESULTS: The vegetal biomembrane was better in promoting healing of the ulcers, especially on the inflammatory phase, confirmed by abundant exudation and wound debridement than the CONTROL group, on the 30th day. There was a greater tendency to angiogenesis followed by re-epithelialization with highest wound healing index on the 90th and 120th days. CONCLUSION: A combined analysis of clinical and histopathological findings suggests that the vegetal biomembrane acted as a factor inducing wound healing, especially on the inflammatory phase, confirmed by abundant exudation of the lesions promoting the transformation of the microenvironment of the chronic venous ulcers, and also stimulating angiogenesis and subsequent re-epithelialization.FUNDAMENTOS: A biomembrana vegetal tem sido usada para tratamento de úlceras cutâneas. OBJETIVOS: Avaliar a ação da biomembrana vegetal no tratamento de úlceras venosas crônicas, comparando-a ao tratamento à base de colagenase. MÉTODOS: Foram selecionados 14 pacientes tratados com biomembrana vegetal e sete com Fibrase® (grupo controle, acompanhados clínico-fotograficamente pelo índice de cicatrização das úlceras (ICU por 120 dias, por meio do software ImageJ, e biopsiados no primeiro e 30º dias para estudo histopatológico. RESULTADOS: A biomembrana vegetal foi superior em relação ao controle na cicatrização das úlceras no 30º dia, especialmente na fase inflamatória, confirmada pela exsudação abundante e

  18. 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.

  19. Chronic Cranial Venous Sinus Thrombosis Retrospective Analysis from Our Hospital in Recent 5 Years%我院近5年慢性颅静脉窦血栓形成的回顾性分析

    Institute of Scientific and Technical Information of China (English)

    王艳; 赵新利; 任玉琴; 吴新艳; 谭军

    2013-01-01

    目的:探讨我院近5年慢性颅静脉窦血栓形成患者的临床特点以及诊断与治疗方法。方法对我院神经内科近5年收治的慢性颅静脉窦血栓形成患者的临床资料进行回顾性分析。结果分别从发病率与危险因素、临床表现、眼底检查与腰椎穿刺、影像学检查以及治疗等5个方面进行总结。结论加深对慢性颅静脉窦血栓形成的了解程度有助于提升其临床诊断水平。%Objective To investigate the hospital nearly five years of chronic cranial venous sinus thrombosis in patients with clinical features and diagnostic and treatment methods. Methods The clinical neurology nearly 5 years admit ed with chronic cranial venous sinus thrombosis in patients with clinical data were retrospectively analyzed. The Results are from morbidity and risk factors, clinical manifestations, fundus examination and lumbar puncture, imaging and therapy five aspects summary. Conclusion deepen the chronic cranial venous sinus thrombosis help to improve the level of understanding of the clinical diagnosis.

  20. 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.

  1. Observation on Chronic Pelvic Pain Syndrome (186 cases) Treated by Capsule for Relieving Blood Stasis%前列通淤胶囊治疗慢性盆腔疼痛综合征186例观察

    Institute of Scientific and Technical Information of China (English)

    孙中明; 鲍严钟

    2003-01-01

    @@ 慢性前列腺炎是影响成年男性生活质量的常见病,估计全球男性的发病率为9%~14%[1].据美国国家卫生研究院(NIH)分类标准(1995年),慢性前列腺炎分为慢性细菌性前列腺炎(Ⅱ类),慢性非细菌性前列腺炎/慢性盆腔疼痛综合征(chronic pelvic pain syndrome,CPPS)(Ⅲ类)以及无症状炎症性前列腺炎(Ⅳ类)三类[2].

  2. The recalcitrant venous leg ulcer - A never ending story?

    NARCIS (Netherlands)

    S.W.I. Reeder (Suzan); M.B. Maessen-Visch (Birgitte); S.I. Langendoen; K.P. de Roos; H.A.M. Neumann (Martino)

    2013-01-01

    textabstractIntroduction: In general, four particular causes of recalcitrant venous leg ulcers may be distinguished. These are foot pump insufficiency, chronic venous compartment syndrome and non-re-canalized popliteal vein thrombosis. The fourth cause of recalcitrant venous leg ulcers is lipodermat

  3. Study on β-aescin's Treatment for Chronic Venous Dysfunction%β-七叶皂苷钠治疗慢性静脉功能不全的研究

    Institute of Scientific and Technical Information of China (English)

    余志红; 苏萍; 王奕

    2011-01-01

    Objective: To explore the mechanism of the domestic β-aescin treating chronic venous insufficiency through observing its actions on the isolated canine saphenous venous tension,venous pressure, venous return and lymphatic drainage. Method :The isolated canine spiral saphenous uenous tension test was performed to detect the activity of the β-aescin. Furthermore,in the comdition of constant canine femoral artery perfusion kept in the extracorporeal circulation ,we measured the changes in the canine femoral artery pressure, femoral artery artery flow and the lymphatic drainage flow after intravenous injection of the drug. Result: When β-aescin was administrated at the dose between 5.0 × 10-5-5.25 × 10-6g·mL-1 ,it could obviously increase the contractile tension of the venous to norepinephrine in a dose-dependent manner. With canine femoral artery perfusion kept constant,β-aescin,whose doses were 50 mg and 100 mg,could reinforce intently the canine femoral venous tension,accelerate the rise of the venous return and lymphatic drainage. Conclusion: The domestic β-aescin extracted from shorea has some therapeutical effect on chronic venous insufficiency by strengthening the venous tension, increasing the venous pressure and promoting venous return and lymphatic drainage.%目的:观察国产β-七叶皂苷钠对犬离体隐静脉张力和对犬静脉压、静脉回流和淋巴同流的作用,从而探讨其治疗慢性静脉功能不全的机制.方法:采用犬离体螺旋隐静脉条张力试验观察β-七叶皂苷钠对犬离体隐静脉收缩张力的影响;另在体外循环保持犬股动脉灌流恒定的条件下,经静脉全身给药后测定犬股静脉压、股静脉流量和淋巴回流量的变化.结果:β-七叶皂苷钠5.0 ×10-5 ~ 5.25×10-6 g·mL-1剂量能明显增加犬离体隐静脉条收缩张力,使其对去甲肾上腺素的反应性增加,且呈剂量依赖性.犬股动脉灌流恒定时,50,100 mg β-七叶皂苷钠能明显加强犬

  4. 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

    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.%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。

  5. 消黄方治疗慢性乙型肝炎(湿热瘀阻型)轻度黄疸的临床疗效%Therapeutic efficacy of Xiaohuang Decotion in chronic hepatitis B patients (damp-heat blood stasis syndrome) with low-grade jaundice

    Institute of Scientific and Technical Information of China (English)

    杨宗国; 陈晓蓉; 陆云飞; 刘成

    2012-01-01

    目的 评价消黄方治疗慢性乙型肝炎(湿热瘀阻型)轻度黄疸的临床疗效.方法 慢性乙型肝炎(湿热瘀阻型)轻度黄疸患者68例,随机数字表简单随机分组,消黄方组38例,熊去氧胆酸(UDCA)组30例.两组基础治疗方案为拉米夫定100 mg,每天1次,口服(或替比夫定600 mg,每天1次,口服);复方甘草酸苷60ml,每天1次,静滴;还原型谷胱甘肽1.2g,每天1次,静滴.UDCA组加UDCA 250 mg,每天3次,口服;消黄方组加消黄方100ml,每天2次,口服.疗程4周.治疗前后观察两组中医证候、肝功能、肝纤维化指标及APRI指数变化.结果 (1)与UDCA组相比,消黄方治疗慢性乙型肝炎(湿热瘀阻型)轻度黄疸的有效率略高(89.5% vs76.7%),但差异无统计学意义(P>0.05).(2)与治疗前相比,消黄方在改善性乙型肝炎轻度黄疸患者肝功能及血脂水平( ALT、AST、GGT、LDH、TBil、DBil、pre -A、TBA、TC、apo-A、HDL等)方面差异有统计学意义(P<0.01或P<0.05).与UDCA组相比,消黄方可有效降低TBil、DBil、TBA、TC水平,提高apo -A含量(P<0.05).(3)与治疗前相比,两组患者透明质酸( HA)均降低,差异具有统计学意义(P<0.05),消黄方对C -Ⅳ也显示出较好的改善作用(P<0.05).(4)与治疗前相比,消黄方组可显著降低患者APRI指数(P<0.01),且与UDCA组比较差异有统计学意义(P<0.05).结论 消黄方可缓解慢性乙型肝炎(湿热瘀阻型)轻度黄疸患者临床症状,改善肝功能、肝纤维化指标,对肝内胆汁淤积性黄疸有较好的临床疗效.%Objective To evaluate the therapeutic efficacy of Xiaohuang Decotion ( XHD) in chronic hepatitis B ( CHB) patients (damp -heat blood stasis syndrome) with low - grade jaundice. Methods Sixty - eight CHB patients ( damp - heat blood stasis syndrome) with low - grade jaundice were assigned to one of two groups by using a random number table; XHD treatment group ( n =38) , and ursodeoxycholic acid (UDCA

  6. [Discussion on "removing stasis and regulating qi and blood" in the scraping therapy].

    Science.gov (United States)

    Wu, Song; Liang, Zhong

    2016-04-01

    Stasis is the critical causative factor and pathological production considered in clinic treatment. Promoting the circulation in blood vessel and removing stasis are equally important in treatment. Stasis is interactive with qi and blood. Removing stasis aims to regulating the circulation of qi and blood. Scraping therapy is one of the major approaches to stasis removal in TCM. In clinical practice, the stasis can be removed with scraping, bleeding and cupping, etc. Additionally, removing stasis with scraping should be combined with regulating qi and blood to enhance the therapeutic effect.

  7. Observation of blood-activating and stasis-dissolving drugs in adjuvant treatment of spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases%活血化瘀辅助治疗慢性肺源性心脏病脾肾阳虚症的观察

    Institute of Scientific and Technical Information of China (English)

    唐润生; 邹才华

    2015-01-01

    目的:探讨活血化瘀辅助治疗慢性肺源性心脏病脾肾阳虚症的疗效。方法选择肺心病脾肾阳虚症患者25例,在常规治疗的基础上加参麦注射液,川芎嗪注射液12d,观察治疗前后两组患者二氧化碳分压(PaCO2)、血氧分压(PaO2)和脑钠肽(BNP)变化情况,并与25例常规治疗组比较。结果治疗组治疗前PaCO2、PaO2、BNP水平分别为(75.3±6.1)mm Hg、(52.8±4.5)mm Hg和(3726.8±651.5)pg/mL,治疗后为(52.4±5.2)mm Hg、(67.3±3.4)mm Hg和(245.6±83.7)pg/mL;对照组治疗前为(74.9±5.1)mm Hg、(53.2±4.1)mm Hg和(3635.4±688.5)pg/mL,治疗后为(66.7±5.5)mm Hg、(58.5±3.7)mm Hg和(533.1±156.5)pg/mL。两组PaCO2、BNP治疗前水平高,治疗后水平下降(P<0.01),PaO2治疗前水平低,治疗后提高(P<0.01),提示两组治疗均有效,治疗组和对照组治疗前PaCO2、PaO2和BNP水平比较差异无统计学意义(P>0.05),治疗组治疗后PaCO2、BNP水平,PaO2水平较对照组好(P<0.01),提示参麦注射液,川芎嗪注射液辅助治疗肺心病治疗优于常规治疗组。结论活血化瘀辅助治疗肺心病可有效改善慢性肺源性心脏病患者血清PaCO2,PaO2和BNP水平,对改善患者心肺功能,提高对临床疗效有益。%ObjectiveTo explore curative effect of blood-activating and stasis-dissolving drugs in adjuvant treatment of spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases. Methods 25 patients with spleen-kidney yang deficiency syndrome of chronic pulmonary heart diseases were selected. They received shenmai injection and tetramethylpyrazine injection for 12 days at the basis of routine treatment. Changes of partial pressure of carbon dioxide in arterial blood (PaCO2), alveolar oxygen partial pressure(PaO2) and brain natriuretic peptide(BNP) before and after treatment of patients in two groups were observed

  8. 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

  9. Venous malformations: classification, development, diagnosis, and interventional radiologic management.

    Science.gov (United States)

    Legiehn, Gerald M; Heran, Manraj K S

    2008-05-01

    Venous malformations are categorized as low-flow vascular malformations within the domain of vascular anomalies and are the most common vascular malformation encountered clinically. Venous malformations are by definition present at birth, undergo pari passu growth, and present clinically because of symptoms related to mass effect or stasis. Although diagnosis can usually be made by clinical history and examination, differentiation from other vascular and nonvascular entities often requires an imaging work-up that includes ultrasound, CT, MR imaging, and diagnostic phlebography. All decisions regarding imaging work-up and decision to treat must be coordinated though referral and discussions with a multidisciplinary team and be based on clearly defined clinical indications. Percutaneous image-guided sclerotherapy has become the mainstay of treatment for venous malformations and involves the introduction of any one of a number of endothelial-cidal sclerosants into the vascular spaces of the lesion, with each sclerosant possessing its own unique spectrum of advantages and disadvantages.

  10. Dongwei Granule in treatment of chronic gastritis with cold obstruction causing qi stagnation and cold obstruction causing blood stasis:a randomized parallel controlled clinical trial%冬胃颗粒治疗寒凝气滞与寒凝血瘀型慢性胃炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    于丽; 李昊燃; 雷春红; 陈晶; 林一帆; 赵明宏; 陆宇平; 高文艳; 巩阳; 刘杨; 季芳

    2012-01-01

    [Objective]To evaluate the clinical efficacy and safety of Dongwei Granule on chronic gastritis with cold obstruction causing qi stagnation (COCQS) and cold obstruction causing blood stasis(COCBS). [Methods]Eighty-six patients of chronic gastritis with COCQS and COCBS were selected for a randomized parallel controlled trial. The 43 cases in the study group were treated with Dongwei Granule 8g tid for seven days, while another 43 in the control group were given hydrotalcite 0. 5g tid, and then the clinical efficacy and safety were investigated. [Results]Both groups have some curative effect, however, the evaluation of curative effect of Dongwei Granule in abdominal pain,belching,anorexia at day 1,3,7,14 gained an advantage over that of hydrotalcite (P<0. 01). Although the effect of hydrotalcite in water brash was slightly superior to that of Dongwei Granule at day 1 and 3, there was no statistical significance(P=0. 5359,0. 7318),and the latter had better effect than the former at day 7 and day 14(P<0. 01). The evaluation of curative effect of Dongwei Granule in water brash gained an advantage over that of hydrotalcite(P<0. 01) by the analytical method of logistic model duplicate measurement,no obvious side effects were found. [Conclusion]Dongwei Granule could effectively prevent and cure chronic gastritis with COCQS and COCBS and quickly relieve the symptoms.%[目的]观察冬胃颗粒治疗寒凝气滞与寒凝血瘀型慢性胃炎的临床疗效及安全性.[方法]86例寒凝气滞与寒凝血瘀型慢性胃炎患者随机分为2组,试验组(43例)给予冬胃颗粒8 g,3次/d,对照组(43例)给予铝碳酸镁片0.5g,3次/d,2药均于两餐间及睡前服用,疗程为2周,观察各组第1、3、7、14天腹痛腹胀、泛酸、嗳气与纳差症状缓解情况,同时观察其安全性.[结果]2组患者均有一定疗效,但冬胃颗粒治疗后第1、3、7、14天患者腹痛腹胀、嗳气、纳差症状疗效指标的评价均优于铝碳酸镁(P<0.01),

  11. Comprehensive treatment of chronic venous leg ulcers%下肢慢性静脉溃疡的综合治疗

    Institute of Scientific and Technical Information of China (English)

    黄楷; 梁思华; 黄明清; 朱晓彤; 吴文洁; 黎洪浩

    2013-01-01

    Objective To discuss comprehensive surgery strategy of chronic venous ulcerations (CVU). Methods From July 2012 to January 2013,the clinical date of ten patients (10 limbs) with CVU treated in our hospital were reviewed. All cases received great saphenous vein high ligation and stripping, transilluminated powered phlebectomy (TIPP), subfascial endoscopic perforators surgery (SEPS) and foam sclerotherapy. Venous Clinical Severity Score (VCSS) was assessed preoperation and three months after surgery. Results Comprehensive surgery was performed successfully in all patients. VCSS was improved from preoperation(12.3 ± 2.06)to postoperation(9.6 ± 1.71). After (6.70±1.45) months follow-up, for all cases, pain relieved and no recurrence of varicose superficial veins presented. Moreover, ulceration healing happened in 8 cases, while, residual ulcerations presented in only 2 cases(diameter<2cm). No recurrence presented in healing ulcerations. Conclusion The comprehensive surgery strategy treating CVU is feasible and safe, with favourable short-term outcomes.%目的探讨下肢慢性静脉溃疡的综合治疗方法。方法回顾性分析2012年7月~2013年1月我科收治的10例下肢慢性静脉溃疡患者(10条患肢)的临床资料,均采用大隐静脉高位结扎加抽剥并联合应用透光曲张静脉刨吸术、泡沫硬化剂注射、腔镜深筋膜下交通静脉结扎术等方法处理小腿病灶。分别在术前及术后3个月对临床症状的改善情况采集数据,按临床严重程度评分(VCSS)方法进行评估。结果患者均成功实施联合手术治疗方案,在术后的VCSS评分项目中得到改善[(12.3±2.06)v s (9.6±1.71)]。随访(6.70±1.45)个月,疼痛较前均有缓解,未发现患肢有曲张浅静脉残余或复发,8例溃疡基本愈合,仅有2例还有残余溃疡,但都控制在2 cm内,已愈合的溃疡未见复发。结论下肢慢性静脉溃疡经正确选择联合治疗方案进

  12. Hemodynamic evaluation of primary chronic venous insufficiency%原发性下肢慢性静脉功能不全的血流动力学评价

    Institute of Scientific and Technical Information of China (English)

    刘明; 周黎丽; 宋福臣; 侯玉芬

    2008-01-01

    原发性下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是血管外科的常见病,严重危害人们的健康。本研究以75例具有临床症状的原发性CVI患者的104条患肢为对象,采用彩色多普勒超声对患肢血流动力学改变进行评价,为临床治疗提供依据。

  13. 下肢慢性静脉功能不全的病因学研究进展%Progress in Etiopathogenesis Study of Chronic Venous Insufficiency of the Lower Limb

    Institute of Scientific and Technical Information of China (English)

    张宏伟; 牟艳; 刘洋; 何春水

    2007-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是临床上常见的周围血管外科疾病,其发病机制复杂.本文主要从三个方面综述其病因学的研究进展,其中着重介绍了白细胞激活及其诱导的炎症反应在CVI病因学中的重要作用.

  14. 血液成分改变在下肢慢性静脉功能不全中的作用%Changes of blood components in chronic venous insufficiency of lower limbs

    Institute of Scientific and Technical Information of China (English)

    叶开创; 陆信武

    2009-01-01

    静脉高压是下肢慢性静脉功能不全(chronic venous insufficiency,CVI)最主要的病理生理学基础,但CVI的发病机制较复杂,至今仍未完全明确。随着“白细胞捕获”假说的提出,静脉血液成分及相关因子的变化引起了学者们的重视,本文就此作一介绍。

  15. 静脉高压对慢性静脉功能不全患者血小板活性的影响%Effect of venous hypertension on platelet reactivity in patients with chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    叶开创; 陆信武; 李维敏; 刘晓兵; 殷敏毅; 施慧华; 蒋米尔

    2010-01-01

    目的 观察体位变化和压力对下肢慢性静脉功能不全(CVI)患者血小板活性的影响.方法 根据纳入和排除标准,选择24例CVI患者作为实验组和20例正常人作为对照组,采用酶联免疫吸附法(ELISA)测定两组人群在不同体位时下肢静脉血液、肘部静脉血液及在外在压力持续作用60 min后血小板P-选择素表达水平.结果 晨起平卧位及站立30 min后两组下肢静脉血液血小板P-选择素表达水平差异无统计学意义(P>0.05);在90~100mm Hg(1 mmHg=0.133 kPa)压力作用60 min后,CVI患者的下肢静脉血液和肘部静脉血液血小板P-选择素均明显高于对照组(P 0. 05 ). After 60 min of simulated venous hypertension in vitro, whatever anticoagulated blood samples from superficial venous blood at the level of dorsum of foot or elbow, P-selectin from washed platelet plasma was significantly increased in patients with CVI as compared with normal control subjects (P < 0. 01 ). Conclusion Platelet hyper-reactivity in patients with CVI, resulted from venous hypertension, may play a major role in the pathogenesis of CVI.

  16. Nursing for patients with acute or chronic pulmonary deep venous thrombosis%急、慢性肺血栓栓塞症患者的护理

    Institute of Scientific and Technical Information of China (English)

    张平; 姜波; 季颖群; 赵广东; 张中和

    2007-01-01

    @@ 静脉血栓栓塞症(venous thromboembolism,VTE)是把深静脉血栓栓塞症(deep venous thrombosis,DVT)和肺栓塞(pulmonary embolism,PE)作为整体理解,肺栓塞是来自全身静脉系统或右心的栓子游离后阻塞肺动脉或其分支引起的肺循环和呼吸功能障碍的临床综合征.

  17. Clinical features of venous insufficiency and the risk of venous thrombosis in older people.

    Science.gov (United States)

    Engbers, Marissa J; Karasu, Alev; Blom, Jeanet W; Cushman, Mary; Rosendaal, Frits R; van Hylckama Vlieg, Astrid

    2015-11-01

    Venous thrombosis is common in older age, with an incidence of 0·5-1% per year in those aged >70 years. Stasis of blood flow is an important contributor to the development of thrombosis and may be due to venous insufficiency in the legs. The risk of thrombosis associated with clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, obtained with a standardized interview was assessed in the Age and Thrombosis Acquired and Genetic risk factors in the Elderly (AT-AGE) study. The AT-AGE study is a case-control study in individuals aged 70 years and older (401 cases with a first-time venous thrombosis and 431 control subjects). We calculated odds ratios (ORs) and corresponding 95% confidence intervals (CI) adjusted for age, sex and study centre. Varicose veins and leg ulcer were associated with a 1·6-fold (95% CI 1·2-2·3) and 3·3-fold increased risk of thrombosis (95% CI 1·6-6·7), respectively, while the risk was increased 3·0-fold (95% CI 2·1-4·5) in the presence of leg oedema. The risk of thrombosis was highest when all three risk factors occurred simultaneously (OR: 10·5; 95% CI 1·3-86·1). In conclusion, clinical features of venous insufficiency, i.e., varicose veins, leg ulcers and leg oedema, are risk factors for venous thrombosis in older people.

  18. 静脉压迫综合征诊治在下肢慢性静脉功能不全中的意义%Diagnosis and Treatment of Iliac Vein Compression Syndrome in Chronic Venous Insufficiency of the Significance

    Institute of Scientific and Technical Information of China (English)

    崔健

    2014-01-01

    目的:探讨髂静脉压迫综合征在下肢慢性静脉功能不全中的临床诊治意义。方法回顾性分析2007年1月至2010年12月亳州市人民医院收治的80例髂静脉压迫综合征伴下肢慢性静脉功能不全患者的临床资料,分析患者的临床治疗和并发症等情况。结果经治疗,下肢功能损害评价优56例,良21例、中2例、差1例;下肢深静脉瓣膜功能损害程度评价优40例,良27例、中10例、差3例。术后随访12~30个月,4例患者发生深静脉血栓,4例发生髂静脉穿孔,并发症发生率为10.0%。结论临床中纠正髂静脉压迫综合征或者联合静脉手术治疗能够有效地改善下肢慢性静脉功能不全的临床症状,并且提示髂静脉压迫综合征可能是下肢慢性静脉功能不全的基础性病变。%Objective To investigate the iliac vein compression syndrome in chronic venous insufficien-cy of the clinical diagnosis and treatment significance. Methods Retrospective analysis of Bozhou City,An-hui Province People′s Hospital,January 2007 to December 2010 were treated 80 cases of iliac vein compres-sion syndrome associated with chronic venous insufficiency in patients with clinical data,analysis of the pa-tient′s clinical treatment and complications and so on. Results After treatment, the evaluation of lower ex-tremity dysfunction excellent 56 cases,good in 21 cases,in two cases,and poor in 1 case;deep venous func-tion evaluated the extent of damage excellent in 40 cases,good in 27 cases,10 cases and poor in 3 cases. Pa-tients were followed up 12-30 months,four patients developed deep vein thrombosis,iliac vein perforation oc-curred in 4 cases,the complication rate was 10. 0%. Conclusion Clinical corrected iliac vein compression syndrome or combined with intravenous surgery can effectively improve chronic venous insufficiency of the clinical symptoms and prompt iliac vein compression syndrome may be chronic venous insufficiency based le-sions.

  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. Normal venous anatomy and physiology of the lower extremity.

    Science.gov (United States)

    Notowitz, L B

    1993-06-01

    Venous disease of the lower extremities is common but is often misunderstood. It seems that the focus is on the exciting world of arterial anatomy and pathology, while the topic of venous anatomy and pathology comes in second place. However, venous diseases such as chronic venous insufficiency, leg ulcers, and varicose veins affect much of the population and may lead to disability and death. Nurses are often required to answer complex questions from the patients and his or her family about the patient's disease. Patients depend on nurses to provide accurate information in terms they can understand. Therefore it is important to have an understanding of the normal venous system of the legs before one can understand the complexities of venous diseases and treatments. This presents an overview of normal venous anatomy and physiology.

  1. Differential Gene Expression Profiles in Coronary Heart Disease Patients of Blood Stasis Syndrome in Traditional Chinese Medicine and Clinical Role of Target Gene

    Institute of Scientific and Technical Information of China (English)

    马晓娟; 殷惠军; 陈可冀

    2009-01-01

    Objective:To investigate the differential gene expression profiles in coronary heart disease(CHD) patients of blood-stasis syndrome(BSS) by oligonucleotide microarray technique,and the clinical significance of target gene.Methods:Subjects were assigned to CHD patients with BSS(n=8),CHD patients without BSS (n=8),and BSS patients without CHD(n=8) based on coronary angiography and the diagnostic criteria of BSS. The sex- and age-matched healthy volunteers(n=8) were enrolled as the control group.Venous bloo...

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

    Directory of Open Access Journals (Sweden)

    Thirawut Sirikham

    2016-06-01

    Full Text Available 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.

  3. Neonatslusele pani aluse Ida-Saksa salapolitsei Stasi

    Index Scriptorium Estoniae

    2002-01-01

    Saksamaa suursaadik Moskvas Ernst-Jörg von Studnitz väidab, et Saksamaa tänavail peadtõstva neonatsluse sünnitajaks ei olnud mitte Adolf Hitleri pärand ega natsluse ideoloogia, vaid endine Ida-Saksa salapolitsei Stasi

  4. 慢性阻塞性肺疾病稳定期营养不良与血瘀证的相关性研究%Study on the Correlation between Malnutrition and Blood-Stasis Syndrome of Patients with Chronic Obstructive Pulmonary Disease in Stable Phase

    Institute of Scientific and Technical Information of China (English)

    蔡蔚斌; 陈兆群; 李嘉勉

    2015-01-01

    Objective: Our study aimed to investigate the relationship between Blood-Stasis syndrome and malnutrition of COPD patients in stable phase, and to provide some new evidences of TCM measure to prevent and combat the disease. Furthermore, the TCM pathological mechanisms of malnutrition in COPD patients were expected to be elucidated. Method: Data of 96 cases from out-patient or in-patient were included to be analyzed by using Chi-square test. Result: Patients of Blood-Stasis syndrome seemed to be easier in risking of malnutrition or in suffering from malnutrition. Conclusion: Blood-Stasis was the prominent TCM syndrome element of COPD in stable phase, and it played an important role in causing malnutrition. Thus, curing the Blood-Stasis syndrome is important in improving the nutritional status of COPD patients in stable phase.%目的:旨在探讨COPD稳定期营养不良与血瘀证之间的关系,进而以期进一步的阐明COPD稳定期营养不良发生的中医机制,并为防治干预COPD稳定期营养不良提供一定的依据。方法:共纳入符合标准的门诊或住院96份病例,统计其血瘀证评分及营养状态评分,并对两者做x2检验。结果:通过分析发现存在营养不良风险及存在营养不良的患者其存在血瘀证的人数要高(P<0.05),血瘀与营养不良发生存在一定的关系。结论:血瘀是影响慢性阻塞性肺疾病稳定期营养状态的重要因素,对慢性阻塞性肺疾病稳定期营养不良的治疗过程应考虑对血瘀证的干预。

  5. 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

  6. Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion

    Directory of Open Access Journals (Sweden)

    Shalini Koppisetty

    2015-01-01

    Full Text Available Inferior vena cava atresia (IVCA is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT, found in approximately 5% of cases of unprovoked lower extremity (LE DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs. Patients with IVC anomalies usually develop compensatory circulation through the collateral veins with enlarged azygous/hemizygous veins. Despite the compensatory circulation, the venous drainage of the lower limbs is often insufficient leading to venous stasis and thrombosis. We describe a case of extensive and bilateral deep venous thrombosis following physical exertion in a thirty-six-year-old male patient with incidental finding of IVCA on imaging.

  7. Multimodal prophylaxis for venous thromboembolic disease after total hip and knee arthroplasty: current perspectives

    Institute of Scientific and Technical Information of China (English)

    LU Ning; Eduardo A. Salvati

    2010-01-01

    Life-threatening in the short term and leading to a high level of morbidity in the long term, venous thromboembolism (VTE) is the most fearful complication following lower limb arthroplasty. With advances in surgical procedure, anesthetic management and postoperative convalescence have altered the risks of venous thromboembolism after total joint arthroplasty in the lower extremity.The pathogenesis of VTE is multifactorial and includes the well-known Virchow's triad of hypercoagulability, venous stasis and endothelial damage. Therefore, it is appropriate to use a multimodal approach to thromboprophylaxis. Despite extensive research, the ideal multimodal prophylaxis against venous thrombolism has not been identified. So this article reviews the recent developments in multimodal prophylaxis for thromboembolism after total joint arthroplasty.

  8. 外科手术在治疗慢性静脉功能不全中的作用%Evaluation of surgical management for treatment of chronic venous insufficiency in lower extremity

    Institute of Scientific and Technical Information of China (English)

    陆民

    2008-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是外科临床的常见病和多发病,我国的发病率约为8%-13%。按1995年American Venous Forum所认同的概念及诊断和分类标准,多种血管疾病均可导致CVI的发生。按病因可分为原发性、继发性和先天性;按血流动力学可分为血液反流性病变和血液回流障碍性病变;按解剖学可涉及浅静脉、深静脉和交通静脉三个系统。外科手术主要针对原发性、血液反流性疾病,范围可涵盖浅静脉、深静脉和交通静脉。

  9. 下肢慢性静脉功能不全与CEAP分类系统%Chronic venous insufficiency of the lower extremities and the CEAP system of classification

    Institute of Scientific and Technical Information of China (English)

    张柏根

    2005-01-01

    下肢慢性静脉功能不全(chronic venous insufficiency,CVI)是最常见的周围血管疾病.人群患病率高达27%,年新发病率0.5%~3.0%.其中静脉性溃疡约占1.5%。CVI的临床表现包括下肢浅静脉扩张或曲张、腿部乏力、沉重、胀痛,水肿、皮肤营养性改变、静脉性溃疡;涉及静脉病变范围.可局限于浅静脉、交通静脉、深静脉或累及整个下肢静脉系统;

  10. The efficacy evaluation way and clinical application for chronic venous insufficiency of the lower limbs%下肢慢性静脉功能不全的评价方式及临床应用

    Institute of Scientific and Technical Information of China (English)

    张福先; 赵辉

    2015-01-01

    下肢慢性静脉疾病(chronic venous diseases,CVD)病人逐年增加,规范CVD疾病的诊断和治疗并进行推广成为血管外科专家们关注的焦点,CEAP分级、VCSS评分及CIVIQ问卷是目前国际上广泛应用的3个评分量表,其评价CVD疾病病情及疗效各有侧重及优缺点,临床常将3个评分量表组合应用,以提高对病情评估的准确性、完整性和有效性.随着对CVD疾病认识的加深,其评估量表必会更加完善、更加稳定有效.%The number of patients suffering from chronic venous diseases (CVD) of the lower limbs keeps increasing year by year. How to standardize the diagnosis and treatment of CVD and make it popularized becomes the focus of the attentions of the vascular surgery experts. Three scales used widely all over the world were known as CEAP classification, VCSS score and CIVIQ questionnaire. These scales have their own merits and demerits, therefore, composite applications were frequently used to elevate the accuracy, integrity and effectiveness of the disease assessment. The scales for CVD evaluation would be more completed, stable and effective in the future accompanying with the growing awareness of CVD.

  11. 下肢慢性静脉功能不全伴脂质硬皮症的手术治疗%Efficacy of Surgery Treatment in Chronic Venous Insufficiency with Lipodermatosclerosis

    Institute of Scientific and Technical Information of China (English)

    李岩; 周海华; 宁勇; 万伯顺; 朱玉敏

    2013-01-01

    目的:探讨手术治疗下肢慢性静脉功能不全(chronic venous insufficiency,CVI)伴脂质硬皮症(lipodermatosclerosis,LDS)的疗效.方法:对36例CVI伴LDS患者行大、小隐静脉高位结扎术联合点式浅静脉分段抽剥术和交通静脉结扎术.采用临床严重程度评分(venous clinical severity score,VCSS)、生活质量量表(chronic venous insufficiency questionnaire,CIVIQ)对其进行术前评估和术后随访,并测量LDS皮下硬结厚度.采用配对t检验比较患者手术前后VCSS、CIVIQ评分和LDS皮下硬结厚度.结果:36例患者均得到随访,随访率100%;随访期为6~12个月,平均8.2个月.36例患者术后CEAP分级均明显改善;VCSS评分均值术前为8.14分,术后为0.56分,手术前后差异有统计学意义(P<0.01);CIVIQ评分均值术前为84.0分,术后为98.2分,手术前后差异有统计学意义(P<0.01);LDS皮下硬结厚度均值术前为1.27 cm,术后为0.03 cm,手术前后差异有统计学意义(P<0.01).结论:采用大、小隐静脉高位结扎术联合点式浅静脉分段抽剥术和交通静脉结扎术治疗CVI伴LDS的患者,可明显改善LDS,促进溃疡愈合,提高患者的生活质量.

  12. 从瘀阻络脉论治子宫内膜异位症%Based on” Blood Stasis of the Collaterals” to Treat Endometriosis

    Institute of Scientific and Technical Information of China (English)

    史杨; 张婷婷; 谭丽; 赵莉; 曹阳

    2012-01-01

    Endometriosis (Ems) is a common and difficult gynecological diseases, blood stasis endometriosis is the pathological basis, and "blood stasis at the collaterals" is the basic endometriosis pathogenesis. The "blood stasis of the collaterals" theory consist of "chronic illness injury collaterals" , "long time pain will entry in collaterals" and "collaterals injured, blood overflow within", which can explain the features of endometriosis that it is difficult to cure, the recurrence is high after operation. In conclusion, we have indicated that eliminate stasis-activating meridian is the important pathway to treat endometriosis.%子宫内膜异位症( endometriosis,EMs)是妇科常见病、难治病.血瘀是子宫内膜异位症的病理基础,而“瘀阻络脉”是子宫内膜异位症的基本病机.“瘀阻络脉”理论由“久病伤络”、“盖久痛必入于络”和“阴络伤,血内溢”组成,可以说明子宫内膜异位症缠绵难愈、术后容易复发的特点.所以子宫内膜异位症的治法应以化瘀通络为主.

  13. Deep venous thrombosis and postthrombotic syndrome: invasive management.

    Science.gov (United States)

    Comerota, A J

    2015-03-01

    Invasive management of postthrombotic syndrome encompasses the two ends of the deep vein thrombosis spectrum, patients with acute iliofemoral deep vein thrombosis and those with chronic postthrombotic iliofemoral venous obstruction. Of all patients with acute deep vein thrombosis, those with involvement of the iliofemoral segments have the most severe chronic postthrombotic morbidity. Catheter-based techniques now permit percutaneous treatment to eliminate thrombus, restore patency, potentially maintain valvular function, and improve quality of life. Randomized trial data support an initial treatment strategy of thrombus removal. Failure to eliminate acute thrombus from the iliofemoral system leads to chronic postthrombotic obstruction of venous outflow. Debilitating chronic postthrombotic symptoms of the long-standing obstruction of venous outflow can be reduced by restoring unobstructed venous drainage from the profunda femoris vein to the vena cava.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Divergent effects of Tlr9 deletion in experimental late venous thrombosis resolution and vein wall injury.

    Science.gov (United States)

    Dewyer, Nicholas A; El-Sayed, Osama M; Luke, Catherine E; Elfline, Megan; Kittan, Nicolai; Allen, Ron; Laser, Adriana; Oostra, Carson; Comerota, Anthony; Hogaboam, Cory; Kunkel, Steven L; Henke, Peter K

    2015-11-01

    Deep-vein thrombosis (DVT) resolves via a sterile inflammatory response. Defining the inflammatory response of DVT may allow for new therapies that do not involve anticoagulation. Previously, we have shown that Toll-like receptor 9 (Tlr9) gene deleted mice had impaired venous thrombosis (VT) resolution. Here, we further characterise the role of Tlr9 signalling and sterile inflammation in chronic VT and vein wall responses. First, we found a human precedent exists with Tlr9+ cells present in chronic post thrombotic intraluminal tissue. Second, in a stasis VT mouse model, endogenous danger signal mediators of uric acid, HMGB-1, and neutrophil extracellular traps marker of citrullinated histone-3 (and extracellular DNA) were greater in Tlr9-/- thrombi as compared with wild-type (WT), corresponding with larger VT at 8 and 21 days. Fewer M1 type (CCR2+) monocyte/macrophages (MØ) were present in Tlr9-/- thrombi than WT controls at 8 days, suggesting an impaired inflammatory cell influx. Using bone marrow-derived monocyte (BMMØ) cell culture, we found decreased fibrinolytic gene expression with exposure to several endogenous danger signals. Next, adoptive transfer of cultured Tlr9+/+ BMMØ to Tlr9-/- mice normalised VT resolution at 8 days. Lastly, although the VT size was larger at 21 days in Tlr9-/- mice and correlated with decreased endothelial antigen markers, no difference in fibrosis was found. These data suggest that Tlr9 signalling in MØ is critical for later VT resolution, is associated with necrosis clearance, but does not affect later vein wall fibrosis. These findings provide insight into the Tlr9 MØ mechanisms of sterile inflammation in this disease process.

  19. [State of the abdominal organs and vessels on the background of simulated venous plethora in the splanchnic vascular system].

    Science.gov (United States)

    Afonin, B V; Noskov, V B; Nichiporuk, I A; Sedova, E A; Goncharova, N P

    2007-01-01

    Ultrasonic investigations of the abdominal organs and splanchnic veins were performed in essentially healthy subjects tilted at 12 degrees and 15 degrees for the period of 12 hrs. and 24 hrs. Tilting produced typical redistribution of venous blood and body liquids toward the cranial end. In its turn, blood redistribution caused excessive venous plethora and abdominal stasis. These were succeeded by expansion of large veins in the abdomen, enlargement of parenchymal organs and contraction of their echogenicity, and thickening of the hollow organs walls. Changes in the gastrointestinal functions before meal included elevated gastric, hepatic and pancreatic secretion, and an increased amount of intestinal content. The investigations demonstrated that stasis of the splanchnic veins altered functioning of the digestive organs in tilted human subjects.

  20. 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

  1. 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

  2. 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

  3. 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.

  4. Lifestyle and venous thrombosis

    NARCIS (Netherlands)

    Pomp, Elisabeth Rebekka

    2008-01-01

    In the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA study), a large population-based case-control study, we investigated lifestyle factors as risk factors for venous thrombosis. Overweight, smoking and alcohol consumption were addressed and pregnancy and

  5. Lower extremity deep venous thrombosis with fatal pulmonary thromboembolism caused by benign pelvic space-occupying lesions--an overview.

    Science.gov (United States)

    Rosenfeld, Hannah; Byard, Roger W

    2012-05-01

    Venous stasis predisposes to thrombosis. One hundred and sixty cases of fatal pulmonary thromboembolism were reviewed to determine how many cases had deep venous thromboses associated with venous blood flow reduction caused by external pressure from benign pelvic masses. Three cases were identified, representing 2% of cases overall (3/160): a 44-year-old woman with a large uterine leiomyoma (1048 g); a 74-year-old man with prostatomegaly and bladder distension (containing 1 L of urine); and a 70-year-old man with prostatomegaly and bladder distension (containing 3 L of urine). Although a rare cause of fatal deep venous thrombosis and pulmonary thromboembolism, space-occupying pelvic lesions can lead to extrinsic pressure on adjacent veins reducing blood flow and causing stasis and thrombosis. Individuals with large pelvic masses may, therefore, be at increased risk of pulmonary thromboembolism from deep venous thrombosis, particularly in the presence of concurrent risk factors such as immobility, thrombophilias, malignancy, and significant cardiopulmonary disease.

  6. 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...

  7. The Clinical Signiifcance of Colour Duplex Ultrasonography in the the Diagnosis of Chronic Venous Insufifciency of Lower Limbs%双功多普勒彩超诊断慢性下肢静脉功能不全的临床意义分析

    Institute of Scientific and Technical Information of China (English)

    张微

    2015-01-01

    Objective To analyse the clinical significance of colour duplex ultrasonography in patients with chronic venous insufficiency in lower limbs. Methods 94 patients in our hospital with chronic venous insufficiency were taken as research subjects, used venous antegrade implementation angiography and duplex doppler ultrasonography. Compared the test results of two methods, and analysed advantage by using duplex doppler ultrasound diagnosis of lower extremity venous insufifciency. Results Duplex doppler ultrasonography of lower extremity venous trafifc detection rate was signiifcantly higher than venous antegrade contrast, the misdiagnosis rate was signiifcantly lower than veins antegrade venous angiography. Conclusion The duplex doppler ultrasound in the diagnosis of deep venous insufficiency is convenient, safe and can effectively improve the accuracy of clinical diagnosis.%目的:探讨双功多普勒彩超在慢性下肢静脉功能不全患者临床诊断中的应用价值。方法选取我院收治的94例慢性下肢静脉功能不全患者作为研究对象,对该组患者实施下肢静脉顺行造影和双功多普勒彩超检查。对比两种检测方法的检测结果,分析采用双功多普勒彩超诊断下肢静脉功能不全的优势。结果双功多普勒彩超检查下肢交通静脉的检出率高于下肢静脉顺行造影,对交通静脉的漏诊率低于下肢静脉顺行造影。结论应用双功多普勒彩超诊断下肢深静脉功能不全患者进行,便捷、安全,可有效提高临床诊断准确率。

  8. Study on Treating Renal Hematuria from Kidney Collateral Stasis%从肾络瘀阻辨治肾性血尿探讨

    Institute of Scientific and Technical Information of China (English)

    周燕妮; 汤水福

    2012-01-01

    肾性血尿是慢性肾脏病的常见症状之一,临床上反复发作,缠绵难愈.文章试从肾络瘀阻的形成及病理变化,探讨其与肾性血尿的关系.提出从肾络瘀阻辩治肾性血尿,尤其是顽固性血尿,是提高临床疗效的重要方法.%Renal hematuria is a common and recurrent symptom of chronic kidney diseases. This paper discusses the formation and pathological changes of kidney collateral stasis, and the relationship with renal hematuria. We propose that treating renal hematuria from kidney collateral stasis, especial for obstinacy hematuria, is an important way to improve the clinical efficacy.

  9. Effect of promoting blood circulation by removing blood stasis on serum transforming growth factor - β1, interleukin -4 and interleukin - 10 levels in female rats with chronic pelvic inflammatory disease%活血化瘀法对慢性盆腔炎雌性大鼠血清TGF-β1和IL-4、IL-10水平的影响

    Institute of Scientific and Technical Information of China (English)

    师伟; 刘瑞芬; 杨晓娜; 徐丽

    2011-01-01

    rat model of chronic pelvic inflammatory disease, 60 rats were divided into model group, high dose cassia tuckahoe capsule group, middle dose cassia tuckahoe capsule group, low dose cassia tuckahoe capsule group and control group randomly, 12 rats in each group; 12 rats in sham operation group and 12 rats in normal group were also selected. ELISA was used to detect the serum levels of TGF - β1, IL-4 and IL - 10 in the seven groups. Results; ①The serum level of TCF - β1 in model group was significantly higher than those in normal group and sham operation group ( P 0. 05) ; the serum level of TGF - β1 in low dose cassia tuckahoe capsule group was significantly higher than that in control group (P 0.05 ) ; the serum levels of IL - 4 and IL-10 in middle dose cassia tuckahoe capsule group and high dose cassia tuckahoe capsule group were higher than those in control group, and there was significant difference in the serum level of IL - 4 ( P 0.05); the serum levels of IL-4 and IL -10 in low dose cassia tuckahoe capsule group were lower than those in control group, and there was no significant difference in the serum level of IL - 4 ( P > 0. 05 ) , while there was significant difference in the serum level of IL-10 ( P < 0.01); the serum levels of IL-4 and IL - 10 in middle dose cassia tuckahoe capsule group were significantly higher than those in high dose cassia tuckahoe capsule group and low dose cassia tuckahoe capsule group. ③There was a significant negative correlation between serum TGF - β1 level and serum IL-4,IL -10 levels ( P < 0. 01) , there was a significant positive correlation between serum IL - 4 level and serum IL - 10 level (P < 0.01) . Conclusion; Promoting blood circulation by removing blood stasis can affect the serum levels of TGF - β1, IL-4 and IL -10 in female rats with chrome pelvic inflammatory disease, and the effect is correlated with the dose of drug, which may be one of the mechanisms of effect of promoting blood circulation by removing

  10. Subfascial endoscopic perforating surgery to treat chronic lower limb venous insufficiency%内镜筋膜下交通静脉结扎术治疗静脉性溃疡

    Institute of Scientific and Technical Information of China (English)

    王深明; 胡作军

    2005-01-01

    下肢交通静脉功能不全在慢性静脉功能不全(chronic venous insufficiency,CVI)肢体皮肤改变,特别是静脉性溃疡发病中的作用早已为人们所注意,早在19世纪60年代,Gay就认识到下肢静脉性溃疡中存在交通静脉功能不全现象。目前虽尚存在一些争沦,但大多数学者仍持认可态度。功能正常的交通静脉由于瓣膜的作用,可保证由下肢浅静脉系统向深静脉系统的单向回流;而当其功能不全时,下肢深静脉的血流就会通过功能不全的交通静脉逆流入浅静脉,引起小腿浅静脉淤血、

  11. Recognition on Surgical Treatment of Chronic Venous Insufficiency in Lower Limb at Present%下肢慢性静脉功能不全治疗的再认识

    Institute of Scientific and Technical Information of China (English)

    时德; 赵渝

    2009-01-01

    周围静脉疾病是临床上的常见病和多发病,其发病率为20%~40%,皮肤营养障碍占2%~5%,发病率比动脉疾病约高10倍,发病机理比动脉疾病复杂,分类方法亦不一致,至今存在着争论。下肢慢性静脉功能不全(chronic venous insufficiency,CVI)按其病因可分为原发性、继发性及先天性;按解剖范围可分为浅、深和交通静脉3个系统,亦即包括浅静脉曲张、深静脉瓣膜功能不全、深静脉血栓形成后遗症、交通静脉瓣膜功能不全等。

  12. Unilateral Loss of Spontaneous Venous Pulsations in an Astronaut

    Science.gov (United States)

    Mader, Thomas H.; Gibson, C. Robert; Lee, Andrew G.; Patel, Nimesh; Hart, Steven; Pettit, Donald R.

    2014-01-01

    Spontaneous venous pulsations seen on the optic nerve head (optic disc) are presumed to be caused by fluctuations in the pressure gradient between the intraocular and retrolaminar venous systems. The disappearance of previously documented spontaneous venous pulsations is a well-recognized clinical sign usually associated with a rise in intracranial pressure and a concomitant bilateral elevation of pressure in the subarachnoid space surrounding the optic nerves. In this correspondence we report the unilateral loss of spontaneous venous pulsations in an astronaut 5 months into a long duration space flight. We documented a normal lumbar puncture opening pressure 8 days post mission. The spontaneous venous pulsations were also documented to be absent 21 months following return to Earth.. We hypothesize that these changes may have resulted from a chronic unilateral rise in optic nerve sheath pressure caused by a microgravity-induced optic nerve sheath compartment syndrome.

  13. 四妙丸加减对湿瘀互结型慢性盆腔炎患者生活质量的影响∗%Influence of Simiao Pill Intervention on the Life Quality of Patients with Damp Heat and Blood Stasis Type of Chronic Pelvic Inflammatory Disease

    Institute of Scientific and Technical Information of China (English)

    王璐; 徐键; 陈学奇

    2016-01-01

    目的:观察四妙丸加减对湿瘀互结型慢性盆腔炎患者临床效果及生活质量的影响。方法将85例诊断为湿瘀互结型慢性盆腔炎患者按随机数字表法分为治疗组43例和对照组42例。治疗组采用四妙丸加减治疗;对照组采用妇科千金胶囊治疗,治疗3个月后进行临床疗效评价,采用WHOQOL-BREF简表进行生活质量评估,分析其临床疗效及对生活质量的改善情况。结果治疗组和对照组总有效率分别为90.70%,71.43%,差异有统计学意义( P0.05);治疗后两组患者生活质量评分均有所提高,治疗组总体评分(104.21±6.67)分,显著高于对照组(89.60±7.31)分,差异有统计学意义(P0.05).After the treatment, score of each dimension of WHOQOL-BREF in both groups were increased, and the total score was(104.21±6.67)in the treatment group and(89.60±7.31)in the control group(P<0.05). Conclusion Simiao pill decoction combined with other Chinese herbs can effectively treat damp heat and blood stasis type of CPID and improve the life quality of the patients.

  14. Biological characteristics of the cerebral venous system and its hemodynamic response to intracranial hypertension

    Institute of Scientific and Technical Information of China (English)

    CHEN Jie; WANG Xi-ming; LUAN Li-ming; CHAO Bao-ting; PANG Bo; SONG Hui; PANG Qi

    2012-01-01

    Background The role of the cerebral venous system (CVS) in intracranial pressure (ICP) regulation remains largely unclear.In the present study,the interaction between ICP and the cerebral venous system and its possible mechanism were investigated with respect to the biological characteristics of the cerebral venous system and its hemodynamic response under increased ICP.@@Methods We created intracranial hypertension animal model,measured and calculated the venous flow velocity and diameter of the outflow terminal of the CVS with color ultrasonic system and recorded the vascular morphology by 3-dimensional anatomical microscopy.Patients who suffered from raised ICP underwent MRI and digital subtraction angiography (DSA) examination to show the length in the vertical direction of the wall of the bridging vein representing the diameter value.Pathological autopsy was performed from bodies of patients who had died from non-cerebral causes to observe the juncture part between the venous sinuses and tributary vertical brain veins.@@Results Under increased ICP conditions,venous drainage through the outlet cuff segment,a unique structure between the bridge vein and sinus,was obstructed and in turn venous blood became congested.Therefore,the increased blood volume worsened the pre-existing ICP according to the well-accepted theory regarding volume-pressure relationship.This phenomenon was described as concurrent “Venogenic intracranial hypertension”,which is characterized by intracranial venous blood stasis responsive to and together with the original increased ICP.@@Conclusions The existence of this special pathophysiological process is prevalent,rather than rare,in various intracranial disorders.This finding would definitely provide new insight into the area of cerebral venous system research.

  15. Cerebral venous sinus thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Renowden, Shelley [Frenchay Hospital, Bristol BS16 1LE (United Kingdom)

    2004-02-01

    A comprehensive synopsis on cerebral venous thrombosis is presented. It emphasizes the various aetiologies, the wide clinical spectrum and the unpredictable outcome. Imaging techniques and pitfalls are reported and the therapeutic options are discussed. (orig.)

  16. Central venous catheter - flushing

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - dressing change Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/22/2016 Updated by: ...

  17. Imaging of the complications of peripherally inserted central venous catheters

    Energy Technology Data Exchange (ETDEWEB)

    Amerasekera, S.S.H. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)], E-mail: steve.amerasekera@nhs.net; Jones, C.M.; Patel, R.; Cleasby, M.J. [Department of Radiology, Good Hope Hospital, Sutton Coldfield, Birmingham (United Kingdom)

    2009-08-15

    Peripherally inserted central catheters (PICC) are widely used to provide central venous access, often in chronically ill patients with long-term intravenous access requirements. There are a number of significant complications related to both insertion and maintenance of PICC lines, including catheter malposition, migration, venous thrombosis, and line fracture. The incidence of these complications is likely to rise as the number of patients undergoing intravenous outpatient therapy increases, with a corresponding rise in radiologist input. This paper provides an overview of the relevant peripheral and central venous anatomy, including anatomical variations, and outlines the complications of PICC lines. Imaging examples demonstrate the range of radiological findings seen in these complications.

  18. Imaging of the complications of peripherally inserted central venous catheters.

    Science.gov (United States)

    Amerasekera, S S H; Jones, C M; Patel, R; Cleasby, M J

    2009-08-01

    Peripherally inserted central catheters (PICC) are widely used to provide central venous access, often in chronically ill patients with long-term intravenous access requirements. There are a number of significant complications related to both insertion and maintenance of PICC lines, including catheter malposition, migration, venous thrombosis, and line fracture. The incidence of these complications is likely to rise as the number of patients undergoing intravenous outpatient therapy increases, with a corresponding rise in radiologist input. This paper provides an overview of the relevant peripheral and central venous anatomy, including anatomical variations, and outlines the complications of PICC lines. Imaging examples demonstrate the range of radiological findings seen in these complications.

  19. A re-appraisal of volume status and renal function impairment in chronic heart failure: combined effects of pre-renal failure and venous congestion on renal function.

    Science.gov (United States)

    Sinkeler, Steef J; Damman, Kevin; van Veldhuisen, Dirk J; Hillege, Hans; Navis, Gerjan

    2012-03-01

    The association between cardiac failure and renal function impairment has gained wide recognition over the last decade. Both structural damage in the form of systemic atherosclerosis and (patho) physiological hemodynamic changes may explain this association. As regards hemodynamic factors, renal impairment in chronic heart failure is traditionally assumed to be mainly due to a decrease in cardiac output and a subsequent decrease in renal perfusion. This will lead to a decrease in glomerular filtration rate and a compensatory increase in tubular sodium retention. The latter is a physiological renal response aimed at retaining fluids in order to increase cardiac filling pressure and thus renal perfusion. In heart failure, however, larger increases in cardiac filling pressure are needed to restore renal perfusion and thus more volume retention. In this concept, in chronic heart failure, an equilibrium exists where a certain degree of congestion is the price to be paid to maintain adequate renal perfusion and function. Recently, this hypothesis was challenged by new studies, wherein it was found that the association between right-sided cardiac filling pressures and renal function is bimodal, with worse renal function at the highest filling pressures, reflecting a severely congested state. Renal hemodynamic studies suggest that congestion negatively affects renal function in particular in patients in whom renal perfusion is also compromised. Thus, an interplay between cardiac forward failure and backward failure is involved in the renal function impairment in the congestive state, presumably along with other factors. Only few data are available on the impact of intervention in volume status on the cardio-renal interaction. Sparse data in cardiac patients as well as evidence from cohorts with primary renal disease suggest that specific targeting of volume overload may be beneficial for long-term outcome, in spite of a certain further decrease in renal function, at least

  20. 下肢静脉功能不全患者手术疗效评价与术后生活质量调查%Evaluation of surgical effectiveness and quality of life in patients with chronic lower limb venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    张智辉; 林少芒; 胡以则; 姚燕丹; 萧剑彬

    2008-01-01

    目的 评价下肢慢性静脉功能不全(chronic venous insufficiency,CVI)患者的手术疗效和术后生活质量.方法 171例CVI患者(193条患肢)根据术式被分为A、B、C三组.采用临床严重程度计分(venous clinical severity score,VCSS)和生活质量调查表(chronic venous insufficiency questionnaire,CIVIQ)评价3种不同术式组术后的VCSS变化和生活质量状况.结果 3组患者术后VCSS记分较术前均显著降低(P0.05);三组术后CIVIQ均在80分以上,各组间差别无统计学意义(P>0.05).结论 根据患者病情选择合适术式,可以有效治疗CVI;应用VCSS和CIVIQ可以客观评价下肢CVI患者的手术疗效和生活质量.

  1. A anquilose tíbio-társica e sua importância na insuficiência venosa crônica Ankle ankylosis and its importance in chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Jorge Ribas Timi

    2009-09-01

    Full Text Available CONTEXTO: O desenvolvimento de anquilose em pacientes com insuficiência venosa crônica (IVC pode ser evidenciado em diversos estágios da patologia através de medidas da amplitude de movimento da articulação do tornozelo tomadas com a utilização de um goniômetro. OBJETIVO: Relacionar a diminuição da amplitude de movimento da articulação tíbio-társica na IVC dos membros inferiores (MMII medida por goniometria com a gravidade da IVC, utilizando-se a classificação CEAP. MÉTODOS: No período de março de 2003 a agosto de 2004, 86 pacientes (67 mulheres e 19 homens com média de idade de 50,6 anos foram submetidos à goniometria do tornozelo. Os indivíduos foram divididos conforme a gravidade da IVC de seus MMII (121 avaliados de acordo com a classificação CEAP. Quarenta membros foram caracterizados como C0 (grupo-controle, 40 como C3, e 41 como C4. As medidas obtidas nos diferentes grupos foram comparadas entre si. RESULTADOS: A média da amplitude de movimento da articulação tíbio-társica do grupo C0 foi de 42,4º (variação de 26-54; a do grupo C3 foi de 37,9º (variação de 10-61; e a do grupo C4 foi de 24,5º (variação de 8-50. A diferença das médias de C4 e C3 foi de 36%, e a de C3 comparada com o grupo-controle (C0, de 11%, caracterizando a maior diferença entre C3 e C4. CONCLUSÃO: A goniometria do tornozelo auxilia a graduar a hipertensão venosa crônica, pois demonstra a existência de correlação entre a gravidade da anquilose e a severidade da IVC.BACKGROUND: Development of ankylosis in patients with chronic venous insufficiency (CVI can be observed in different stages of the disease as the ankle range of motion is measured by a goniometer. OBJECTIVE: To relate a reduced ankle range of motion in patients with CVI of the lower limbs measured by goniometry and the severity of CVI according to the CEAP classification. METHODS: From March 2003 to August 2004, 86 patients (67 females and 19 males with a mean

  2. 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

  3. Analysis of nicergoline in treating elderly chronic cerebrospinal venous insufifciency%尼麦角林治疗老年慢性脑血管功能不全的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    王君; 王瑞祥

    2015-01-01

    目的:探讨尼麦角林治疗老年慢性脑血管功能不全的临床效果。方法采用随机数表法将本院神经内科2012年7月至2014年7月收治的162例老年慢性脑血管功能不全患者分为尼麦角林组和常规组,每组各81例。常规组患者采用常规治疗方法,尼麦角林组患者在常规治疗基础上加用尼麦角林。比较两组患者治疗的临床效果。结果治疗前,两组患者大脑中动脉、椎动脉的彩色多普勒超声检测指标[舒张期末流速(Vd)、收缩期峰流速(Vs)、阻力指数(RI)、搏动指数(PI)]比较差异均无显著性(P>0.05);治疗后12周,两组患者的Vd、Vs、RI、PI较组内治疗前明显好转,差异均具有显著性(P<0.05),且尼麦角林组患者的Vd、Vs、RI、PI优于常规组,差异具有显著性(P<0.05)。治疗前两组患者的简易精神状态检查量表(MMSE)评分比较差异无显著性(P>0.05);治疗后两组患者MMSE评分较治疗前均显著提高(P<0.05),且尼麦角林组患者的MMSE评分[(24.5±1.3)分]显著高于常规组[(22.9±1.5)分],差异具有显著性(P<0.05)。治疗后12周,尼麦角林组患者治疗总有效率(91.36%)高于常规组(76.54%),差异具有显著性(P<0.05)。结论尼麦角林可以改善老年慢性脑血管功能不全患者的临床症状及大脑血管血流情况,同时可以显著提高临床治疗效果。%Objective To investigate the clinical effect of nicergoline in treatment of elderly patients with chronic cerebrospinal venous insufficiency. Method Used random number table method to selected 162 cases of elderly patients with chronic cerebrovascular venous insufficiency from July 2012 to July 2014 in our hospital as research objects, they were divided into nicergoline group and routine group, 81 cases in each group. Routine group patients were treated with conventional methods, on the basis of

  4. [Homocysteine and venous thromboembolism].

    Science.gov (United States)

    Monnerat, C; Hayoz, D

    1997-09-06

    Congenital homocysteinuria is a rare inherited metabolic disorder with early onset atherosclerosis and arterial and venous trombosis. Moderate hyperhomocysteinemia is more frequently encountered and is recognized as an independent cardiovascular risk factor. Several case-control studies demonstrate an association between venous thromboembolism and moderate hyperhomocysteinemia. A patient with moderate hyperhomocysteinemia has a 2-3 relative risk of developing an episode of venous thromboembolism. The occurrence of mild hyperhomocysteinemia in heterozygotes for the mutation of Leiden factor V involves a 10-fold increase in the risk of venous thromboembolism. The biochemical mechanism by which homocysteine may promote thrombosis is not fully recognized. Homocysteine inhibits the expression of thrombomodulin, the thrombin cofactor responsible for protein C activation, and inhibits antithrombin-III binding. Treatment with folic acid reduces the plasma level of homocysteinemia, but no study has demonstrated its efficacy in reducing the incidence of venous thromboembolism or atherosclerosis. Hyperhomocysteinemia should be included in the screening of abnormalities of hemostasis and thrombosis in patients with idiopathic thromboembolism, and mild hyperhomocysteinemia may justify a trial of folic acid.

  5. Ileofemoral venous thrombectomy.

    Science.gov (United States)

    Lindhagen, J; Haglund, M; Haglund, U; Holm, J; Scherstén, T

    1978-01-01

    Twentyeight patients with ileofemoral venous thrombosis were treated surgically. Five of the patients had moderate degree of venous congestion, 18 patients had phlegmasia alba dolens and five patients had phlegmasia coerulea dolens. The mean age was 54 years, range 15-80 years, and 15 were men and 13 were women. In all cases the thrombosis was verified by phlebography. Thrombectomy was performed with a Fogarty venous thrombectomy catheter. Peroperative phlebography was used in most cases to guarantee complete extraction of thrombotic material. No operative pulmonary embolism or mortality was encountered. Postoperative continuous heparin infusion in the thrombectomized segment was used for the first week followed by dicumarol treatment. The patients were followed from 6 months to 4 years postoperatively. In two patients thrombectomy was not possible to perform. One of these patients developed a pronounced postthrombotic syndrome, the other developed venous congestion of more moderate degree. Excellent long-term time results were obtained in 82% of the patients and satisfactory in 14%. Thrombectomy is an efficient treatment of ileofemoral venous thrombosis.

  6. Plasma endothelin in coronary venous blood from patients with either stable or unstable angina.

    OpenAIRE

    Stewart, J T; Nisbet, J A; Davies, M J

    1991-01-01

    STUDY OBJECTIVE--To test the hypothesis that the active coronary endothelial lesions in unstable angina raise the endothelin concentration in coronary venous blood. DESIGN--Systemic and coronary venous blood samples were obtained from unselected patients with the clinical syndromes of either stable or unstable angina at the time of cardiac catheterisation and coronary arteriography. Control venous blood samples were obtained from healthy laboratory workers and from patients with chronic renal...

  7. Provisional Matrix Deposition in Hemostasis and Venous Insufficiency: Tissue Preconditioning for Nonhealing Venous Ulcers

    Science.gov (United States)

    Parker, Tony J.; Broadbent, James A.; McGovern, Jacqui A.; Broszczak, Daniel A.; Parker, Christina N.; Upton, Zee

    2015-01-01

    Significance: Chronic wounds represent a major burden on global healthcare systems and reduce the quality of life of those affected. Significant advances have been made in our understanding of the biochemistry of wound healing progression. However, knowledge regarding the specific molecular processes influencing chronic wound formation and persistence remains limited. Recent Advances: Generally, healing of acute wounds begins with hemostasis and the deposition of a plasma-derived provisional matrix into the wound. The deposition of plasma matrix proteins is known to occur around the microvasculature of the lower limb as a result of venous insufficiency. This appears to alter limb cutaneous tissue physiology and consequently drives the tissue into a ‘preconditioned’ state that negatively influences the response to wounding. Critical Issues: Processes, such as oxygen and nutrient suppression, edema, inflammatory cell trapping/extravasation, diffuse inflammation, and tissue necrosis are thought to contribute to the advent of a chronic wound. Healing of the wound then becomes difficult in the context of an internally injured limb. Thus, interventions and therapies for promoting healing of the limb is a growing area of interest. For venous ulcers, treatment using compression bandaging encourages venous return and improves healing processes within the limb, critically however, once treatment concludes ulcers often reoccur. Future Directions: Improved understanding of the composition and role of pericapillary matrix deposits in facilitating internal limb injury and subsequent development of chronic wounds will be critical for informing and enhancing current best practice therapies and preventative action in the wound care field. PMID:25785239

  8. 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....

  9. Effects of Blood-Activating and Stasis-Resolving Drugs on Tumor Formation and Metastasis

    Institute of Scientific and Technical Information of China (English)

    QIAN Yan-fang; WANG Xiao-jing; DUAN Shu-min

    2009-01-01

    @@ In order to summarize and analyze the internal relations of tumor formation and metastasis to blood-stasis syndrome and the influential factors of blood-activating and stasis-resolving drugs (BASRD) on tumor inhibition and metastasis, and to grasp the opportunity of selecting and using BASRD, the authors have retrieved by the computer the relative literature published from 1985 to 2006 in Full-text Database of Chinese Periodicals with "BASRD" and "cancer" as retrieval words.

  10. Self-Expanding, Tough Biodegradable Elastomers for Wound Stasis

    Science.gov (United States)

    2015-08-06

    drinking water was pro- vided.On thedayof surgery, animalswereanesthetizedwithan intramuscular injection of 5 mg/kg Telazol (50 mg/mL of tilet- amine ...venous pressure) were recorded every 5 min. End-tidal CO2 (ETCO2) was also measured throughout the experiment (V9004; SurgiVet, Waukesha, WI). A...challenge, the closed-cavity nature of noncompressible hemorrhage is not captured . In another class of models [9,10], a suture was placed

  11. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension: new clinical observations.

    Science.gov (United States)

    Belcaro, G; Cesarone, M R; Dugall, M

    2004-01-01

    Aescin + essential phospholipids (AEPL) topical gels are used for local treatment of venous and microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with AEPL. Active ingredients are escinate and essential phospholipids (EPL). The aim of this new study was the evaluation of the efficacy of the effects of AEPL gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Patients were assessed measuring skin flux with laser-Doppler flowmetry (LDF). After 2 weeks of local treatment, all individual values (100%) were significantly decreased (p < 0.05), indicating an improvement in the microcirculation. In all treated patients, flux decreased at least 30% (indicating a decrease in the level of venous microangiopathy) (p < 0.05). Considering these observations, topical treatment with AEPL in areas of venous microangiopathy is beneficial, can prevent ulceration, and improves the skin healing processes.

  12. 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.

  13. 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

  14. Jugular venous oximetry

    Directory of Open Access Journals (Sweden)

    Avanish Bhardwaj

    2015-01-01

    Full Text Available The measurement of saturation of venous blood as it drains out of brain by sampling it from the jugular bulb provides us with an estimate of cerebral oxygenation, cerebral blood flow and cerebral metabolic requirement. Arterio-jugular venous difference of the oxygen content (AVDO 2 and jugular venous oxygen saturation (SjVO 2 values per se helps clinicians in identifying the impairment of cerebral oxygenation due to various factors thereby prompting implementation of corrective measures and the prevention of secondary injury to the brain due to ischaemia. SjVO 2 values are also used for prognostication of patients after traumatic brain injury and in other clinical situations. Sampling and measuring SjVO 2 intermittently or continuously using fibreoptic oximetry requires the tip of the catheter to be placed in the jugular bulb, which is a relatively simple bedside procedure. In the review below we have discussed the relevant anatomy, physiology, techniques, clinical applications and pitfalls of performing jugular venous oximetry as a tool for measurement of cerebral oxygenation.

  15. Central venous line - infants

    Science.gov (United States)

    A central venous line (CVL) is a long, soft, plastic tube that is put into a large vein in the chest. WHY IS A CVL USED? A CVL is often put in when a baby cannot get a ... (MCC). A CVL can be used to give nutrients or medicines to a ...

  16. 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.

  17. Venous Thromboembolism in China

    Institute of Scientific and Technical Information of China (English)

    赵永强

    2005-01-01

    @@ Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are two manifesttions of venous thromboembolism (VTE) . Although the controversy remained,it has been widely accepted for many years that Chinese people have lower incidence of VTE than Caucasians with the different etiology and clinical features.

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Haage, Patrick; Schmitz-Rode, Thomas [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany); Krings, Timo [Department of Neuroradiology, University of Technology Aachen, Pauwelsstrasse 30, 52057 Aachen (Germany)

    2002-11-01

    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

  20. Absence of venous valves in mice lacking Connexin37.

    Science.gov (United States)

    Munger, Stephanie J; Kanady, John D; Simon, Alexander M

    2013-01-15

    Venous valves play a crucial role in blood circulation, promoting the one-way movement of blood from superficial and deep veins towards the heart. By preventing retrograde flow, venous valves spare capillaries and venules from being subjected to damaging elevations in pressure, especially during skeletal muscle contraction. Pathologically, valvular incompetence or absence of valves are common features of venous disorders such as chronic venous insufficiency and varicose veins. The underlying causes of these conditions are not well understood, but congenital venous valve aplasia or agenesis may play a role in some cases. Despite progress in the study of cardiac and lymphatic valve morphogenesis, the molecular mechanisms controlling the development and maintenance of venous valves remain poorly understood. Here, we show that in valved veins of the mouse, three gap junction proteins (Connexins, Cxs), Cx37, Cx43, and Cx47, are expressed exclusively in the valves in a highly polarized fashion, with Cx43 on the upstream side of the valve leaflet and Cx37 on the downstream side. Surprisingly, Cx43 expression is strongly induced in the non-valve venous endothelium in superficial veins following wounding of the overlying skin. Moreover, we show that in Cx37-deficient mice, venous valves are entirely absent. Thus, Cx37, a protein involved in cell-cell communication, is one of only a few proteins identified so far as critical for the development or maintenance of venous valves. Because Cxs are necessary for the development of valves in lymphatic vessels as well, our results support the notion of common molecular pathways controlling valve development in veins and lymphatic vessels.

  1. [Endovascular treatment of persistent dysuria and chronic pelvic pain in women with pelvic varicose veins].

    Science.gov (United States)

    Neĭmark, A I; Shelkovnikova, N V

    2012-01-01

    The results of the examination and treatment of 16 patients aged from 26 to 46 years with persistent urinary disorders and chronic pelvic pain due to severe pelvic varicose veins are presented. Using ultrasound with color Doppler mapping and venography of renal and ovarian vein for evaluation of condition of the venous system of the pelvis, the significant dilation of the internal iliac, ovarian and uterine veins with a pronounced decrease in blood flow in veins up to the stasis of blood, accompanied by flow turbulence and powerful backflow of renal blood through ovarian veins were found in all patients. According to uroflowmetry, there was a decrease in detrusor tone and a violation of evacuation capacity of the bladder. Evaluation of microcirculation using LDF allowed to diagnose congestive hemodynamic type of microcirculation. Scleroembolization for varicose ovarian vein with Gianturco coil and ethoxysclerol was performed in all patients. Positive therapeutic effect in the form of eliminating varicose pelvic veins, pain relieve, disappearance of persistent dysuria, and the remission of chronic cystitis was achieved in 86% of women. This intervention provided the normal outflow of blood from the pelvic veins, contributed to the normalization of uroflowmetry data and restoration of normal microcirculation in the urinary bladder.

  2. 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)

  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. Venous thromboembolism and pregnancy

    Directory of Open Access Journals (Sweden)

    Maristella D’Uva

    2010-03-01

    Full Text Available Maristella D’Uva1, Pierpaolo Di Micco2, Ida Strina1, Giuseppe De Placido1Department of Obstetrics and Gynecology and Human Reproduction, “Federico II” University of Naples, Naples, Italy; 2Internal Medicine Division, Buonconsiglio Fatebenefratelli Hospital of Naples, Naples, ItalyAbstract: In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods.Keywords: thrombophilia, venous thromboembolism, recurrent pregnancy loss, factor V Leiden

  5. A review of the current management and treatment options for superficial venous insufficiency.

    Science.gov (United States)

    Zhan, Henry T; Bush, Ruth L

    2014-10-01

    The recognition of lower extremity venous disease as a significant cause of morbidity and lower quality of life, afflicting up to 25 % of Western populations, has led to rapid and drastic improvements in treatment options as well as an increasing awareness of the disease. Superficial venous disease, a frequent medical problem encountered in clinical practices, is now a common reason for referral to providers offering a spectrum of interventions. Venous guidelines have been set forth by the American Venous Forum and Society for Vascular Surgery covering simple spider veins to chronic venous ulcerations. (Gloviczki et al. J Vas Surg 53:2S-48S, 2011) This review provides an overview of the modern management of varicose veins and venous insufficiency.

  6. Venous Leg Ulcers.

    Science.gov (United States)

    Vivas, Alejandra; Lev-Tov, Hadar; Kirsner, Robert S

    2016-08-02

    This issue provides a clinical overview of venous leg ulcers, focusing on prevention, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  7. 生活质量调查表在下肢慢性静脉功能不全术后随访中的应用%The use of life quality questionnaire for postoperative follow-up of patients with chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    张岚; 张柏根

    2004-01-01

    目的评估下肢慢性静脉功能不全(chronic venous insufficiency,CVI)术后的生活质量.方法采用生活质量调查表(chronic venous insufficiency questionnaire,CIVIQ)4类20项调查内容,评价3种不同术式组:浅静脉组术式、交通静脉组术式、深静脉组术式169例CVI患者术后的生活质量;CIVIQ均值80分以上定为良好.结果 3种术式CIVIQ均值分别为:浅静脉组84±15;交通支组88±14;深静脉组82±16.结论深静脉瓣膜重建术后患者生活质量是满意的;CIVIQ的应用是合理和可行的.

  8. [Present and future in the management of venous vascular diseases].

    Science.gov (United States)

    Gavorník, Peter; Dukát, Andrej; Gašpar, Ľudovít; Gavorníková, Eva

    2015-02-01

    The prevalence and the incidence of chronic and acute venous vascular disease has been shown to be globally very high, in both industrialized and developing countries. Chronic venous diseases of lower extremities are being an integral part of the third millennium's deadly angiopandemy, at the present time. The rate of the most severe cases with advanced stage of venous failure is approximately twice as high in the population (2.1 %) as has been assumed so far. Among venoactive drugs (VAD), micronized purified flavonoid fraction (MPFF) of diosmin hesperidin remains the agent with the highest degree of recommendation and it also indicated to pharmacotherapeutical support of leg ulcer healing, along with sulodexide and pentoxifylline. Compressive sclerotherapy, liquid or foam, is a safe and effective invasive method to treat telangiectasias, reticular varicose veins and subcutaneous varicose veins. Direct oral anticoagulants (DOAC) represent one of the therapeutic and preventive options of deep venous thrombosis (DVT) and of venous thromboembolism (VTE) with a limitation in patients with malignant conditions and in pregnancy. The most effective is triple simultaneous pharmaco-kinezio-mechano-phlebothromboemboloprophylaxis. Superficial vein thromboses longer than 5 cm are indicated to anticoagulant therapy too.

  9. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    Cardiac output is largely controlled by venous return, the driving force of which is the energy remaining at the postcapillary venous site. This force is influenced by forces acting close to the right atrium, and internally or externally upon the veins along their course. Analogue models....... The venous capacitance is also non-linear, but may be considered linear under certain conditions. The models have to include time varying pressure sources created by respiration and skeletal muscles, and if the description includes the upright position, the partly unidirectional flow through the venous...

  10. Cell evolution and Earth history: stasis and revolution.

    Science.gov (United States)

    Cavalier-Smith, Thomas

    2006-06-29

    oxidation ca 570 Myr ago reduced methane flux at source, stabilizing Phanerozoic climates. I argue that the major cellular innovations exhibit a pattern of quantum evolution followed by very rapid radiation and then substantial stasis, as described by Simpson. They yielded organisms that are a mosaic of extremely conservative and radically novel features, as characterized by De Beer's phrase 'mosaic evolution'. Evolution is not evenly paced and there are no real molecular clocks.

  11. Chronic obstructive pulmonary disease (copd) with spontaneous pneumothorax the curative effect of central venous catheter pleural closed drainage through research%慢性阻塞性肺病合并自发性气胸通过中心静脉导管胸腔闭式引流的疗效研究

    Institute of Scientific and Technical Information of China (English)

    刘书明

    2015-01-01

    Objective Central venous catheter pleural exploration and comparison analysis and thick silica gel catheter closed drainage in the treatment of patients with chronic obstructive pulmonary disease (copd) with spontaneous pneumothorax.Methods 100 cases of chronic obstructive pulmonary disease with central venous catheter group of 50 cases with spontaneous aerosols are divided into thick silica gel catheter group of 50 cases, the comparative analysis of two groups of clinical treatment effect and the incidence of adverse reactions.Results Postoperative incidence of adverse reactions of central venous catheter group was lower than that in group thick silica gel catheter (P< 0.05) and significant difference.Conclusions Choose plan of central venous catheter pleural closed drainage diagnosis and treatment of copd with spontaneous pneumothorax patients clinical effect is satisfactory.%目的:探索和对比分析中心静脉导管胸腔闭式引流和粗硅胶导管治疗慢性阻塞性肺病合并自发性气胸患者的临床效果。方法:100例慢性阻塞性肺疾病合并自发性气胸患者分为中心静脉导管组50例与粗硅胶导管组50例,对比分析两组的临床治疗效果和不良反应发生率。结果:术后的不良反应发生率中心静脉导管组明显低于粗硅胶导管组(P<0.05),差距有显著性意义。结论:选用中心静脉导管胸腔闭式引流诊疗方案治疗慢阻肺合并自发性气胸患者临床效果满意。

  12. Foot reflex zone massage type of blood stasis in patients with Chronic Abacterial Prostatitis inprostatic fluid of TNF - αIL - 8%足部反射区按摩对气滞血瘀型慢性非细菌性前列腺炎患者前列腺液中TNF-α、IL-8的影响

    Institute of Scientific and Technical Information of China (English)

    常德贵; 李广森; 张培海; 吴天浪; 张朝德

    2011-01-01

    目的:研究足部反射区按摩对慢性非细菌性前列腺炎患者前列腺液中TNF-α、IL-8的影响.方法:采用随机、对照的方法,选取慢性非细茵性前列腺炎患者96例,分为两组,即治疗组为足部反射区按摩("肾"、"输尿管"、"膀胱"、"前列腺"、"睾丸")加前列通瘀胶囊、对照组为前列通瘀胶囊,每组各48例.经过1个疗程(4周)治疗后,观察2组患者前列腺液中TNF-α、IL-8水平的变化.结果:治疗纽和对照组患者前列腺液中TNF-α治疗前的平均值分别为(69.36±12.65)pg/mL和(70.49±7.25)pg/mL,差异无统计学意义(P>0.05),治疗后分别下降为(54.04±11.08)pg/mL和(59.15±8.38)pg/mL,两组治疗前后差异有统计学意义(P0.05),治疗后分别下降为(3.76±1.73)ng/mL和(4.42±1.45)ng/mL,两组治疗前后差异有统计学意义(P<0.05).活疗组较对照组有更明显改善,差异有统计学意义(P<0.05).结论:足部反射区按摩治疗慢性非细菌前列腺炎的机理可能是降低前列腺液中TNF-α、IL-8水平的表达.%Objective: To study the effect of pedal reflex zone massage on TNF - α, IL - 8 in prostatic fluid for the patients with chronic nonbacteral prostatitis. Methods: A total of 96 patients with chronic nonbacteral prostatitis were randomly divided into trail group and control group. Both groups included 48 patients and the course lasted for 4 weeks. The patients in trial group were treated with Pedal reflex zone massage (“kidney” “ureter” “bladder prostate testis”) combining with Qianlietonsyu capsule,while in control group were treated only by Qianlietongyu capsule, and observed the change of TNF - ct and IL - 8 in prostatic fluid of each group after one curative period (4 weeks later ). Results: The mean of TNF - αin trial group and control group were ( 69.36±12.65) ps/mL and (70.49 ±7.25) pg/mL respectively before treatment and there was no statistical significant difference ( P > 0.05 ) between them. After

  13. Management of venous ulcers: State of the art.

    Science.gov (United States)

    Marola, Silvia; Ferrarese, Alessia; Solej, Mario; Enrico, Stefano; Nano, Mario; Martino, Valter

    2016-09-01

    Venous ulceration is a complex and serious problem that affects 1-2% of the global elderly population (>65 years), and its incidence is constantly increasing. The population group with higher risk of development of venous ulceration is the elderly. These lesions have a significant negative impact on patients' quality of life. Our aim was to analyze the state of the art, starting with the medical literature review. The evidence supports that managing chronic wounds with a multidisciplinary wound care team significantly increases wound healing and reduces the severity of wound-associated pain and the required daily wound treatments compared with persons who are not managed by such a team.

  14. Distribution and quantitative study of inflammatory cells infiltration in vessel wall of chronic venous insufficiency in lower limbs%下肢慢性静脉功能不全血管壁炎性细胞浸润分布和定量研究

    Institute of Scientific and Technical Information of China (English)

    陈智年; 李凤臣; 王国华; 李泽宇; 张桂凌; 任洁

    2012-01-01

    目的 探讨淋巴细胞、单核-巨噬细胞和肥大细胞在血管壁中的浸润与下肢慢性静脉功能不全( chronic venous insufficiency of low limbs,CVI)之间的关系.方法 收集不同临床分期下肢慢性静脉功能不全的主干(中段)标本,C2 ~ C3级20例,C4~C6级17例,对照组(正常静脉)7例.采用免疫组织化学染色LCA,CD68和甲苯胺蓝特殊染色分别检测淋巴细胞、单核-巨噬细胞和肥大细胞表达.结果 C2 ~ C3级、C4~C6级标本中单核-巨噬细胞表达与正常对照组差异有统计学意义(F=3.56,P<0.05);C2 ~ C3级、C4 ~ C6级标本中肥大细胞表达与正常对照组差异有统计学意义(F =5.13,P<0.05).结论 单核-巨噬细胞和肥大细胞在血管壁的浸润可能是慢性静脉功能不全的一个重要病因.%Objective To investigate the relationship between infiltration of lymphocytes,monocyte-macrophage and mast cells in vessel wall and chronic venous insufficiency of low limbs.Methods The bole specimens (midpiece) of chronic venous insufficiency in low limbs in different clinical stages were collected,20 cases of C2- C3,17 cases of C4- C6 and 7 cases of normal venous tissue.Immunohistochemical staining and toluidine bluestaining were used to detect the expression of lymphocyte,monocyte-macrophage and mast cells.Results There were significant differences in the expression levels of monocyte-macrophage cells between C2- C3,C4- C6 specimens and normal control group ( F =3.56,P < 0.05 ) ; there were significant differences in the expression levels of mast cells between C2- C3,C4- C6 specimen and normal control group ( F =5.13,P < 0.05 ).Conclusions Infiltration of monocyte-macrophages and mast cells in vessel wall could be an important cause of chronic venous insufficiency.

  15. Models of the venous system

    DEFF Research Database (Denmark)

    Mehlsen, J

    2000-01-01

    . The venous capacitance is also non-linear, but may be considered linear under certain conditions. The models have to include time varying pressure sources created by respiration and skeletal muscles, and if the description includes the upright position, the partly unidirectional flow through the venous...

  16. 下肢慢性静脉性溃疡病因学及治疗研究%Progress in the etiology and therapy of chronic venous leg ulcers

    Institute of Scientific and Technical Information of China (English)

    陈琉; 常李; 陈金鳌

    2012-01-01

    下肢慢性静脉性溃疡( CVLU)是下肢静脉功能不全的常见并发症.许多CVLU反复发作,久治不愈,形成难治性溃疡,成为临床治疗中的辣手问题.笔者就近年来CVLU病因学研究进展,分期疗法和个体化治疗方法进行评价及综述.%Chronic venous leg ulceration (CVLU) is a frequent complication of lower limb venous insufficiency. Many cases of CVLU, which are slow to heal and frequently recur, and finally develop into refractory ulcers, have become a difficult problem in clinical practice. This paper reviews the recent progress in the etiology of CVLU, and its staging and individualized treatment.

  17. 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.

  18. Cerebral sinus venous thrombosis

    Science.gov (United States)

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

    2013-01-01

    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

  19. Sarcoidosis mimicking a venous ulcer: a case report.

    Science.gov (United States)

    Joshi, Smita S; Romanelli, Paolo; Kirsner, Robert S

    2009-11-01

    Sarcoidosis--a chronic, multisystem disease of unknown etiology characterized by noncaseating granulomas--may cause ulcerative lesions, particularly in African American women. A case of ulcerative sarcoidosis mimicking a venous ulcer is presented. The patient is a 44-year-old African American hypertensive, obese woman with a nonhealing medially based lower leg ulcer of 3 years' duration clinically consistent with a venous ulcer. The ulcer did not heal with compression therapy and pentoxifylline. Subsequent biopsies showed granulomatous inflammation consistent with sarcoidosis. When intralesional triamcinolone was added to compression therapy, the ulcer resolved after 3 months. Given its propensity toward formation on the lower extremities and ulcerative and atrophic appearance, ulcerative sarcoidosis should be considered in the differential diagnosis of a venous ulcer refractory to standard therapy, especially in African American women.

  20. How to objectively assess jugular primary venous obstruction

    Directory of Open Access Journals (Sweden)

    Paolo Zamboni

    2014-12-01

    Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

  1. Condrosarcoma de la tibia con metástasis al sistema nervioso central

    OpenAIRE

    Toro G., Gabriel; Suárez C., Héctor A.; Mena R., Hernando

    2011-01-01

    Se analiza el caso de un hombre de 48 años de edad con condrosorcoma de la tibia derecha que dio metástasis al lóbulo occipital izquierdo. Encontramos en nuestra parcial revisión bibliográfica que solamente Talerman en 1970 comunicó un caso semejante.

  2. 原发性慢性静脉功能不全与基质金属蛋白酶、上皮间质转化之间的关系%The Relationship between Epithelial-mesenchimal Transition,Matrix Metalloproteinase and Primary Chronic Venous Insufficiency

    Institute of Scientific and Technical Information of China (English)

    周亚东

    2013-01-01

    原发性慢性静脉功能不全(PCVI)是血管外科的常见病与多发病,其病因及发病机制至今未明,关于其发病原因及机制有多种学说,其中血管重构学说是近年来研究的热点和重点,并且得到广泛认同.随着研究的深入,发现基质金属蛋白酶(MMPs)与静脉血管重构有着密切的联系,但具体作用机制不明,而近年来的研究发现,MMPs在上皮间质转化过程中也占重要地位.%Primary chronic venous insufficiency (PCVI )is a common and frequently-occurring disease in vascular surgery. The etiology and pathogenesis are still unknown, and there are a variety of theories ahout its causes and mechanisms, among which vascular remodeling theory is a widely recognized focus and emphasis of the research in recent years. Along with the deepening of the study it's found that matrix metalloproteinases ( MMPs ) and venous vascular remodeling are closely linked, but the exact mechanism is unknown. Recent studies have also found an important role of MMPs in the process of epithelial-mesenchymal transition.

  3. Overview of venous thromboembolism.

    Science.gov (United States)

    Abad Rico, José Ignacio; Llau Pitarch, Juan Vicente; Rocha, Eduardo

    2010-12-14

    Thrombosis occurs at sites of injury to the vessel wall, by inflammatory processes leading to activation of platelets, platelet adherence to the vessel wall and the formation of a fibrin network. A thrombus that goes on to occlude a blood vessel is known as a thromboembolism. Venous thromboembolism begins with deep vein thrombosis (DVT), which forms in the deep veins of the leg (calf) or pelvis. In some cases, the DVT becomes detached from the vein and is transported to the right-hand side of the heart, and from there to the pulmonary arteries, giving rise to a pulmonary embolism (PE). Certain factors predispose patients toward the development of venous thromboembolism (VTE), including surgery, trauma, hospitalization, immobilization, cancer, long-haul travel, increased age, obesity, major medical illness and previous VTE; in addition, there may also be a genetic component to VTE. VTE is responsible for a substantial number of deaths per annum in Europe. Anticoagulants are the mainstay of both VTE treatment and VTE prevention, and many professional organizations have published guidelines on the appropriate use of anticoagulant therapies for VTE. Treatment of VTE aims to prevent morbidity and mortality associated with the disease, and any long-term complications such as VTE recurrence or post-thrombotic syndrome. Generally, guidelines recommend the use of low molecular weight heparins (LMWH), unfractionated heparin (UFH) or fondaparinux for the pharmacological prevention and treatment of VTE, with the duration of therapy varying according to the baseline characteristics and risk profile of the individual. Despite evidence showing that the use of anticoagulation prevents VTE, the availability of several convenient, effective anticoagulant therapies and the existence of clear guideline recommendations, thromboprophylaxis is underused, particularly in patients not undergoing surgery. Greater adherence to guideline-recommended therapies, such as LMWH, which can be

  4. Placement of a port catheter through collateral veins in a patient with central venous occlusion.

    Science.gov (United States)

    Teichgräber, Ulf Karl-Martin; Streitparth, Florian; Gebauer, Bernhard; Benter, Thomas

    2010-04-01

    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.

  5. 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.

  6. Acroangiodermatite (pseudossarcoma de Kaposi: uma condição raramente reconhecida. Um caso na planta do pé associado a insuficiência venosa crônica Acroangiodermatitis (pseudo-Kaposi sarcoma: a rarely-recognized condition. A case on the plantar aspect of the foot associated with chronic venous insufficiency

    Directory of Open Access Journals (Sweden)

    Maria Inês Fernandes Pimentel

    2011-08-01

    Full Text Available A acroangiodermatite ou pseudossarcoma de Kaposi é entidade angioproliferativa incomum relacionada a insuficiência venosa crônica, fístulas arteriovenosas, membros paralisados, cotos de amputação, síndromes vasculares e condições trombóticas. Apresenta-se, em geral, como máculas, pápulas ou placas purpúricas no dorso dos pés (especialmente hálux e maléolos. Relatamos um caso de acroangiodermatite afetando a região plantar, por dois anos sem diagnóstico, para o qual a coloração histológica por hematoxilina-eosina e a marcação imuno-histoquímica com CD34 foram decisivas. A paciente tinha insuficiência venosa crônica e a lesão respondeu bem ao uso de bandagens elásticas e repouso com a perna elevadaAcroangiodermatitis, often known as pseudo-Kaposi sarcoma, is an uncommon angioproliferative entity related to chronic venous insufficiency, arteriovenous fistulae, paralysed limbs, amputation stumps, vascular syndromes and conditions associated with thrombosis. It presents most frequently as purple macules, papules or plaques in the dorsal aspects of the feet, especially the toes, and the malleoli. We report a case of acroangiodermatitis in the plantar aspect of the foot, misdiagnosed for two years, in which haematoxylin-eosin hystopathological stain and immunolabeling with CD34 histochemistry examination were decisive for diagnosis. Patient had chronic venous insufficiency. The lesion responded well to the treatment with a combination of leg elevation and compression

  7. Increased rheumatoid factor and deep venous thrombosis

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... venous thrombosis. CONCLUSIONS: Increased rheumatoid factor in the general population was associated with up to 3-fold increased long-term risk and up to 9-fold increased 1-year risk of deep venous thrombosis....... was incident deep venous thrombosis. There were no losses to follow-up. RESULTS: During 368381 person-years, 670 individuals developed deep venous thrombosis. A rheumatoid factor concentration ≥ vs venous thrombosis, with multivariable adjusted hazard...

  8. 腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全%Experience of endovenous radiofrequency combined with TriVex in treatment of chronic venous insufficiency in lower extremity

    Institute of Scientific and Technical Information of China (English)

    林少芒; 张智辉; 姚燕丹; 萧剑彬

    2009-01-01

    目的 评价腔内射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全的疗效.方法 150例下肢静脉功能不全患者(150条患肢)随机分为A、B两组,每组75例.A组行大隐静脉射频闭合术联合曲张浅静脉TriVex刨吸术,B组行大隐静脉高位结扎抽剥术联合曲张浅静脉TriVex刨吸术.比较两组的手术时间、术后首次下床时间、术后48 h的疼痛视觉模拟评分(VAPS)值、术后住院天数、皮下血肿和皮下硬结的发生情况;比较患者对手术的自身评价、手术前后美国静脉联盟CEAP分级、临床严重程度计分(VCSS)、慢性静脉功能不全问卷(CIVIQ)生活质量评分的变化.结果 两组手术时间差异不显著,A组术后疼痛轻、下床时间早、住院天数少、皮下血肿发生率低,但皮下硬结发生率高于B组;术后4周对手术的评价A组优于B组;A、B手术前后CEAP分级、VCSS、CIVIQ评分变化差别有统计学意义(P0.05).结论 利用射频闭合术联合TriVex刨吸术治疗下肢静脉功能不全有效,且微创、并发症少、更具人性化;CEAP临床分级、VCSS临床计分和CIVIQ生活质量评分可用于评价其疗效.%Objective To evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.Methods One hundred and fifty patients with chronic venous insufficiency (150 limbs) were randomly assigned to Group A (75 limbs) and Group B (75 limbs).Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex.Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex.The postoperative pain,average hospital stay and short-term results in hospital were compared between the two groups.Self-assessment of the operation 4 weeks after,changes of CEAP classification,venous clinical severity score (VCSS) and chronic venous

  9. 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.

  10. 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...

  11. Venous ulcers - self-care

    Science.gov (United States)

    Risk factors for venous ulcers include: Varicose veins History of blood clots in the legs ( deep vein thrombosis ) Blockage of the lymph vessels , which causes fluid to build up in the legs Older age, ...

  12. Venous Thromboembolism and Atherosclerosis link

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2011-01-01

    @@ Past always venous thrombosis and arterial thrombo-sis as a separate system to be discussed, the main reason is because there is between the anatomical and pathologi-cal physiological differences, the clinical manifestations are very different.

  13. Central venous catheter - dressing change

    Science.gov (United States)

    ... during cancer treatment Bone marrow transplant - discharge Central venous catheter - flushing Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/17/2016 Updated by: ...

  14. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny;

    2006-01-01

    The aim of the study was to investigate the bacterial profile of chronic venous leg ulcers and the importance of the profile to ulcer development. Patients with persisting venous leg ulcers were included and followed for 8 weeks. Every second week, ulcer samples were collected and the bacterial s...

  15. Influence of Slippery Pacemaker Leads on Lead-Induced Venous Occlusion

    Science.gov (United States)

    Yang, Weiguang; Bhatia, Sagar; Obenauf, Dayna; Resse, Max; Esmaily-Moghadam, Mahdi; Feinstein, Jeffrey; Pak, On Shun

    2016-11-01

    The use of medical devices such as pacemakers and implantable cardiac defibrillators have become commonplace to treat arrhythmias. Pacing leads with electrodes are used to send electrical pulses to the heart to treat either abnormally slow heart rates, or abnormal rhythms. Lead induced vessel occlusion, which is commonly seen after placement of pacemaker or ICD leads, may result in lead malfunction and/or SVC syndrome, and makes lead extraction difficult. The association between the anatomic locations at risk for thrombosis and regions of venous stasis have been reported previously. The computational studies reveal obvious flow stasis in the proximity of the leads, due to the no-slip boundary condition imposed on the lead surface. With the advent of recent technologies capable of creating slippery surfaces that can repel complex fluids including blood, we explore computationally how local flow structures may be altered in the regions around the leads when the no-slip boundary condition on the lead surface is relaxed using various slip lengths. The findings evaluate the possibility of mitigating risks of lead-induced thrombosis and occlusion by implementing novel surface conditions (i.e. theoretical coatings) on the leads.

  16. 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.)

  17. 祛瘀止痛汤治疗心血瘀阻型胸痹%Remove stasis and pain decoction treating blood stasis type thoracic obstruction

    Institute of Scientific and Technical Information of China (English)

    侯公楷; 张彦峰

    2015-01-01

    objective To observe the analgesic decoction in the treatment of dispelling blood stasis and blocking clini-cal curative effect. Methods Choose 120 patients with obstruction of heartache as the research object,were random-ly divided into control group and test group,each 60 cases. Control group given conventional western medicine treat-ment,treatment group patients give the quasi square and remove stasis pain herb tea soup oral treatment;Two groups of patients with 7 days for a period of treatment,after treatment of 4 patients clinical symptoms and electrocardiogram curative effect. Results The treatment group patients clinical symptoms relieve the total effective rate was 83. 3% ;Control group was 68. 3%( P < 0. 05),the treatment group electrocardiogram period 86. 7% ,control group is 73. 3% ;Compare between the two groups have statistical significance( P < 0. 05). Conclusion Since the quasi square and remove stasis pain decoction in the treatment of blood stasis resistance type obstruction clinical curative effect is distinct.%目的:观察自拟方祛瘀止痛汤治疗心血瘀阻型胸痹的临床疗效。方法选取胸痹心痛患者120例为研究对象,随机分为对照组和试验组各60例,对照组给予西医常规治疗,试验组给予自拟方祛瘀止痛汤口服汤药治疗;2组均以7 d 为1个疗程,治疗4个疗程后观察临床症状及心电图疗效。结果治疗组临床症状缓解总有效率为83.3%,对照组为68.3%(P <0.05);治疗组心电图改善率86.7%,对照组为73.3%,2组比较差异有统计学意义(P <0.05)。结论自拟祛瘀止痛汤治疗心血瘀阻型胸痹,具有活血化瘀、行气止痛之功,能明显改善临床症状及心电图疗效。

  18. Unna Boot in Venous Ulcer Treatment: Evaluation of 30 patients

    OpenAIRE

    Acıpayam, Mehmet; Zor, M. Hakan; Altınay, Levent; Uncu, Hasan; Halıcı, Ümit

    2013-01-01

    Aim: We aim to evaluate the results of the Unna boot practice with this prospective study. Material and Methods: This study included a total of 30 patients (1 female, 29 male; ages 23–56, mean 33.5) admitted to outpatient clinic with chronic venous leg ulcers. All patients were treated with Unna's boot. This treatment combined with oral calcium dobesilat 500 mg tabletorally twice a day. As the ulcer was healing, the treatment continued with calcium dobesilate tablets and compres...

  19. The Flux Balance Analysis based on Network Model of Myocardial Cell Energy Metabolism of Blood Stasis Syndrome in Coronary Heart Disease%基于冠心病血瘀证心肌细胞能量代谢网络模型的流平衡分析

    Institute of Scientific and Technical Information of China (English)

    袁肇凯; 简维雄; 黄献平; 张月娟; 孙安会; 夏世靖

    2016-01-01

    Objective To investigate the characteristics of myocardial cell energy metabolism changes of acute and chronic blood stasis syndrome of coronary heart disease (CHD). Methods (1) The CHD myocardial cell energy metabolism network model of blood stasis syndrome were built up by using FluxExplorer software platform. (2) The coronary arterial blood glucose, fatty acids and blood oxygen content, which were taken from from healthy control group, CHD with chronic blood stasis syndrome, CHD with acute blood stasis syndrome groups, were detemined by GC-MS technology and automatic blood gas analyzer. (3) The results were into network model, the characteristic parameters of acute and chronic CHD with blood stasis syndrome were analyzed by flux balance. Results (1) Three groups of glycolytic, lipid metabolism and the TCA cycle has been activated, but after the network operations metabolite values were significantly different in each group, which showed a healthy control group > CHD with chronic blood stasis syndrome > CHD with acute blood stasis group trend. (2) The glucose, fatty acids and blood oxygenation content and yield of ATP in three groups showed a decreasing trend. The key enzymes of glycolysis (HK, PFK, PK), key enzymes of the TCA cycle (Cs, Icdh, Od) showed consistent changes. Conclusion The form of different CHD with acute blood stasis and chronic blood stasis syndromes were closely related tolevels of myocardial energy metabolism in the body.%目的 探讨冠心病(coronary artery heart disease, CHD)急、慢性血瘀证心肌细胞能量代谢的变化特点.方法 (1)运用FluxExplorer软件平台构建起的CHD血瘀证心肌细胞能量代谢网络模型;(2)应用GC-MS技术和血气自动分析仪从健康对照、CHD慢性血瘀证、CHD急性血瘀证三组大鼠模型中取冠状动脉血检测葡萄糖、脂肪酸及血氧含量;(3)检测结果代入网络模型,通过流平衡分析CHD急、慢性血瘀证状态下参数的特点. 结果 (1)三组的糖

  20. Management of varicose veins and venous insufficiency.

    Science.gov (United States)

    Hamdan, Allen

    2012-12-26

    Chronic venous disease, reviewed herein, is manifested by a spectrum of signs and symptoms, including cosmetic spider veins, asymptomatic varicosities, large painful varicose veins, edema, hyperpigmentation and lipodermatosclerosis of skin, and ulceration. However, there is no definitive stepwise progression from spider veins to ulcers and, in fact, severe skin complications of varicose veins, even when extensive, are not guaranteed. Treatment options range from conservative (eg, medications, compression stockings, lifestyle changes) to minimally invasive (eg, sclerotherapy or endoluminal ablation), invasive (surgical techniques), and hybrid (combination of ≥1 therapies). Ms L, a 68-year-old woman with varicose veins, is presented. She has had vein problems over the course of her life. Her varicose veins recurred after initial treatment, and she is now seeking guidance regarding her current treatment options.

  1. Efficacy of Percutaneous Point Incision Drainage in Chronic Venous Insufficiency Combined with Lipodermatosclerosis%点式引流手术在下肢慢性静脉功能不全伴脂质硬皮症中的疗效

    Institute of Scientific and Technical Information of China (English)

    李岩; 周海华; 宁勇; 万伯顺; 朱玉敏

    2015-01-01

    Objective:To explore the efficacy and feasibility of percutaneous point incision dralnage in patients with chronic venous insufficiency(CVI) combined with lipodermatosclerosis(LDS) .Methods:A total of 60 patients with CVI combined with LDS were randomly divided into the experiment group and the control group ,with 30 patients in each .High ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of lower limbs combined with percutaneous point incision dralnage were conducted in the experiment group ,while high ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of lower limbs was conducted in the control group .The thickness of subcutaneous sclerosis , the venous clinical severity score(VCSS) ,the chronic venous insufficiency questionnalre(CIVIQ) and the level of transforming growth factor‐β1(TGF‐β1) were compared between the two groups after the operations .Results:After the operations ,the patients had been followed up for 6 to 12 months with an average of 8 .6 months ,and the follow‐up rate was 100% .The clinical manifestation of LDS in the experiment group was relieved faster than that in the control group .There were 7 cases ,2 cases with subcutaneous induration at 3 months ,6 months after operation ,respectively ,in the experiment group ,while there were 22 cases ,15 cases ,respectively ,in the control group(P<0 .01) .VCSS was lower ,while CIVIQ was better ,in the experiment group ,than that in the control group ,at 1 ,3 ,6 month after surgery(P<0 .01) .The level of TGF‐β1 in the experiment group was significantly lower than that in the control group at 1 month after surgery (P< 0 .05) .Conclusions:High ligation and stripping on superficial veins of lower limbs and ligation on perforating veins of low limbs ,combined with percutaneous point incision dralnage ,demonstrated a good efficacy on CVI combined with LDS .%目的:探讨点式引流手术在下肢慢性静脉功能不全(chronic

  2. Effect of mitral valve prosthesis design and orientation on intraventricular flow and blood stasis

    Science.gov (United States)

    May-Newman, Karen; Campos, J.; Montes, R.; Ramesh, V.; Moon, J.; Reider, C.; Martinez-Legazpi, P.; Bermejo, J.; Rossini, Lorenzo; Del Alamo, Juan C.

    2016-11-01

    Abnormal blood flow patterns are linked with thromboembolism (TE), especially in the presence of medical devices such as mitral valve prostheses (MVP). We performed PIV on a customized silicone left ventricle (LV) in a mock circulatory loop. We measured the velocity field in the long-axis midplane for 3 different MVP: a porcine bioprosthesis (BP), a tilting disk valve in two orientations: towards the LV lateral (TD-L) or the anterior wall (TD-A), and a bileaflet valve with anti-anatomical orientation (BL). Diastolic LV vortices were tracked and related to measures of blood stasis based on LV residence time. The BP and the TD-L produced flow patterns similar to those measured in patients. The TD-A showed a complete reversal of diastolic vortices. The BL design had increased apical blood stasis, which may lead to increased TE risk.

  3. Contemporary diagnosis of venous malformation

    Directory of Open Access Journals (Sweden)

    Lee BB

    2013-11-01

    Full Text Available BB Lee,1 I Baumgartner21Department of Surgery, George Washington University, Washington, DC, USA; 2Swiss Cardiovascular Center, University Hospital Bern, Bern, SwitzerlandAbstract: Venous malformation is a congenital vascular malformation resulting from defective development during various stages of embryogenesis and selectively affecting the venous system. Depending on the embryologic stage when the developmental arrest occurred, the clinical presentation of venous malformation is extremely variable in location, extent, severity, natural progression, and hemodynamic impact. Extratruncular lesions occur in the earlier stages of embryonic life, and retain characteristics unique to mesenchymal cells (angioblasts, growing and proliferating when stimulated internally (eg, by menarche, pregnancy, and hormones or externally (eg, by trauma or surgery. These lesions also have a significant hemodynamic impact on the venous system involved, in addition to the risk of localized intravascular coagulopathy. However, truncal lesions, as defective developments along the late stage, no longer carry the risk of proliferation and recurrence due to lack of mesenchymal characteristics. Although, they often have serious hemodynamic consequences due to direct involvement of the main vein trunk. Therefore, a thorough clinical history and careful physical examination should be followed by an appropriate combination of noninvasive and less invasive tests (eg, Doppler ultrasonography, magnetic resonance imaging, computed tomography to confirm the clinical impression as well as to define the extent and severity of the venous malformation. Invasive tests, eg, phlebography or angiography, are seldom needed for the diagnosis per se. Additional evaluation for coagulation abnormalities, eg, D-dimer and fibrinogen levels, is generally recommended, especially for the treatment of surgery and endovascular candidates with extensive lesions to assess the localized intravascular

  4. 下肢慢性静脉功能不全外科治疗的现状与争议%Discussion on the surgical treatment of chronic venous insufficiency

    Institute of Scientific and Technical Information of China (English)

    王深明

    2005-01-01

    下肢慢性静脉功能不全(chmnic venous insuffciencv,CVI)是常见的血管外科疾病,多种静脉疾病均可导致静脉功能不全,按其病因可分为原发性、继发性、先天性;按解剖范围可分为浅、深和交通静脉3个系统。下肢CVI的外科治疗主要用于原发性CVI和部分继发性CVI的病例。虽深静脉瓣膜重建术对纠正深静脉反流确有一定疗效,

  5. 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.

  6. Thirty-six Cases of Hyperglycemia Treated by Promoting Blood Circulation to Remove Stasis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Thirty-six cases with hyperglycemia were treated with the method of promoting blood circulation and removing stasis in a course of 4 weeks. The treatment was significantly effective in correcting the abnormal viscosity of the blood by reducing the contents of total plasmic cholesterol (TC), triglyceride (TG) and apoprotein B (apoB), while the level of the apoprotein A (apoA) was elevated.

  7. Asymmetric ecological conditions favor Red-Queen type of continued evolution over stasis.

    Science.gov (United States)

    Nordbotten, Jan Martin; Stenseth, Nils C

    2016-02-16

    Four decades ago, Leigh Van Valen presented the Red Queen's hypothesis to account for evolution of species within a multispecies ecological community [Van Valen L (1973) Evol Theory 1(1):1-30]. The overall conclusion of Van Valen's analysis was that evolution would continue even in the absence of abiotic perturbations. Stenseth and Maynard Smith presented in 1984 [Stenseth NC, Maynard Smith J (1984) Evolution 38(4):870-880] a model for the Red Queen's hypothesis showing that both Red-Queen type of continuous evolution and stasis could result from a model with biotically driven evolution. However, although that contribution demonstrated that both evolutionary outcomes were possible, it did not identify which ecological conditions would lead to each of these evolutionary outcomes. Here, we provide, using a simple, yet general population-biologically founded eco-evolutionary model, such analytically derived conditions: Stasis will predominantly emerge whenever the ecological system contains only symmetric ecological interactions, whereas both Red-Queen and stasis type of evolution may result if the ecological interactions are asymmetrical, and more likely so with increasing degree of asymmetry in the ecological system (i.e., the more trophic interactions, host-pathogen interactions, and the like there are [i.e., +/- type of ecological interactions as well as asymmetric competitive (-/-) and mutualistic (+/+) ecological interactions]). In the special case of no between-generational genetic variance, our results also predict dynamics within these types of purely ecological systems.

  8. Patient-specific analysis of blood stasis in the left atrium

    Science.gov (United States)

    Flores, Oscar; Gonzalo, Alejandro; Garcia-Villalba, Manuel; Rossini, Lorenzo; Hsiao, Albert; McVeigh, Elliot; Kahn, Andrew M.; Del Alamo, Juan C.

    2016-11-01

    Atrial fibrillation (AF) is a common arrhythmia in which the left atrium (LA) beats rapidly and irregularly. Patients with AF are at increased risk of thromboembolic events (TE), particularly stroke. Anticoagulant therapy can reduce the risk of TE in AF, but it can also increase the risks of adverse events such as internal bleeding. The current lack of tools to predict each patient's risk of LA thrombogenesis makes it difficult to decide whether to anticoagulate patients with AF. The aim of this work is to evaluate blood stasis in patient-specific models of the LA, because stasis is a known thrombogenesis risk factor. To achieve our aim, we performed direct numerical simulations of left atrial flow using an immersed boundary solver developed at the UC3M, coupled to a 0D model for the pulmonary circulation. The LA geometry is obtained from time-resolved CT scans and the parameters of the 0D model are found by fitting pulmonary vein flow data obtained by 4D phase contrast MRI. Blood stasis is evaluated from the flow data by computing blood residence time together with other kinematic indices of the velocity field (e.g. strain and kinetic energy). We focus on the flow in the left atrial appendage, including a sensitivity analysis of the effect of the parameters of the 0D model. Funded by the Spanish MECD, the Clinical and Translational Research Institute at UCSD and the American Heart Association.

  9. Metástasis pulmonares en osteosarcoma neoadyuvancia, tratamiento quirúrgico y supervivencia

    Directory of Open Access Journals (Sweden)

    Germán L Farfalli

    2015-04-01

    Full Text Available La supervivencia global a 5 años de los pacientes con osteosarcoma no-metastásico es del 60-70%, mientras que la misma se reduce a 10-30% en los pacientes con enfermedad diseminada. El objetivo de nuestro estudio fue determinar supervivencia y factores pronósticos en un grupo de pacientes con metástasis pulmonares por osteosarcoma tratados quirúrgicamente. Se realizó una búsqueda retrospectiva en nuestra base de datos oncológica entre 1992-2006, y 38 pacientes fueron incluidos en el estudio. La edad media al momento del diagnóstico fue de 18 ± 9.4 años (3-45 y el seguimiento promedio de 57 ± 53.8 meses (12-231. Todos fueron tratados con quimioterapia, resección oncológica del tumor primario y de las metástasis pulmonares. Se analizó la supervivencia a 5 y 10 años de la serie y los siguientes factores pronósticos: edad, sexo, localización del tumor primario, metástasis de inicio, recidiva local, número de metástasis extirpadas y la respuesta al tratamiento de quimioterapia (necrosis tumoral. La supervivencia global fue de 29% a los 5 años (IC95%:14.5-43.5 y de 26% a los 10 años (IC95%:12-40. Se encontró una diferencia estadísticamente significativa entre los buenos y malos respondedores a la quimioterapia: 53% (IC95%: 28-78 vs. 8% (IC95%: 0-20 (p = 0.0008. No se observó relación estadísticamente significativa entre los demás factores pronósticos analizados. La supervivencia a 5 y 10 años de los pacientes con osteosarcoma y metástasis pulmonares tratados con quimioterapia y resección quirúrgica continúa siendo pobre. Los pacientes con buena respuesta a la quimioterapia neoadyuvante presentan un mejor pronóstico oncológico.

  10. 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.)

  11. Dutch Venous Ulcer guideline update.

    Science.gov (United States)

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-01

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates.

  12. A young man with nonhealing venous ulcers

    NARCIS (Netherlands)

    Vloedbeld, M. G.; Venema, A. W.; Smit, A. J.

    2006-01-01

    A 35-year-old man presented with nonhealing ulcers at an atypical location on his left foot, caused by a combination of venous insufficiency (after deep venous thrombosis) and arterial insufficiency. The underlying cause was Buerger's disease.

  13. [Automatic regulator of venous pressure and venous outflow in the perfusion system].

    Science.gov (United States)

    Smirnov, L M; Levinskiĭ, M M; Kharnas, S Sh; Cherniak, V A

    1976-01-01

    A scheme for automatic regulation of the venous pressure and venous blood outflow during extracorporeal circulation is proposed. The system consists of a photoelectric sensor placed on a tube led out of the major venous trunkline, a converter and an electromechanical eccentric clamp that compresses the venous trunkline, all of which secures stabilization of the controlled values.

  14. Observing the Effect of Aescuven Forte combined with Diosmin tablets in treatment of Chronic venous insufficiency%迈之灵合并地奥司明治疗下肢静脉功能不全的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈培栋

    2015-01-01

    目的:观察迈之灵合并地奥司明治疗下肢静脉功能不全的临床疗效。方法:随机抽取2012年4月~2013年6月在我院住院的患者50例(患有下肢静脉功能不全)。采用双盲随机分组法分为两组,其中25例单用地奥司明片,每日午餐、晚餐时各服1次,1片/次。联合治疗组25例,服用地奥司明片,每日午餐、晚餐时各服1次,1片/次;同时服用迈之灵片,每日早晚各服1次,2片/次,疗程为20d。结果:合并治疗组治疗前后小腿周径的变化有显著差异,联合治疗组治愈率及总有效率分别为40%、92%,单用地奥司明治疗组治愈率及总有效率分别为24%、68%。结论:迈之灵合并地奥司明治疗下肢静脉功能不全的疗效确切、可靠,值得推广。%Objective:To study the evaluation of Aescuven Forte combined with Diosmin tablets in treatment of Chronic venous insufficiency. Methods:50 cases of patients being in Chronic venous insufficiency from April 2012~June 2013 in our hospital,were randomly divided into one group of 25 cases, single use of Dosimin tablets ,oral 0.45g per time,two times a day, the other group of 25 cases ,oral administration of diosmin tablets 0.45g per time,two times per day, Aescuven Forte 2 tablets per time ,two times a day.Two groups of treatment for 20 days. Results:After 20 days treatment, there were significant differences between combined treatment group in crus weeks diameter. The clinical cure rate and total effective rate was 40% and 92% in the combined treatment group , 24% and 68%in monotherapy group. Conclusion:The effect of combing Aescuven Forte with Dosimin on Chronic venous insufficiency is exact and reliable.

  15. Central venous line complications and tip detection

    OpenAIRE

    Ameneh Rezaee Gheshlaghi; Hamid Zamani Moghadam Dolu; Elham Pishbin; Maryam Salehi

    2015-01-01

    Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central veno...

  16. [Female gonadal venous insufficiency].

    Science.gov (United States)

    Fernández-Samos, R; Zorita, A; Ortega, J M; Morán, C; Morán, O; Vázquez, J; Vaquero, F

    1993-01-01

    The varicocele is a disease recognized and studied in the man. Dilatation of the ovarian veins and the pelvic varicosities secondaries to a varicocele in the woman is a rarely described disease but, if it were researched, it could be more frequent. Diverse syndromes of chronic abdominal pain in the woman with unrecognized etiology and associated with urologic and/or gynecologic symptomatology could be caused by this pathology, but the absence of a clinical description difficult the diagnosis of the most part of cases. The practice of gonadal selective venographies shows a high percentage of dilatation of the gonadal veins associated to a dilatation of the pelvic veins and of the lower limbs veins. The study of the anatomy of the gonadal veins shows diverse anomalies respect to the classical descriptions. Furthermore, the varicocele could be the cause of a high part of the "essential" varicosities presents during the pregnancy. We present a case that instead of being treated by Services of Urology or Gynecology, it was treated by the Vascular Surgery Service. So, the literature about the respect was reviewed. We think that, some entities, like the feminine varicocele, ovarian vein syndrome, pelvic congestion syndrome chronic pelvic pain, pelvic varicosities, vulvar varicosities and some "essential" pregnant varicosities at the lower limbs could be enclosed into the same clinical entity (with a common etiology, physiopathology, clinical presentation and treatment). It should be intending to unify criteria (etiologic, diagnostic and therapeutics criteria) by the different Specialized Unities in such type of pathology.

  17. Compartment syndrome in patients with massive venous thrombosis after inferior vena cava filter placement.

    Science.gov (United States)

    Mesfin, Addisu; Lum, Ying Wei; Nayfeh, Tariq; Mears, Simon C

    2011-03-11

    Massive venous thrombosis, which can occur acutely after inferior vena cava filter placement, has 2 forms: phlegmasia cerulea dolens and phlegmasia alba dolens. In phlegmasia cerulea dolens, complete occlusion of venous outflow occurs. In the milder phlegmasia alba dolens version, collateral venous flow out of the limb remains despite the venous thrombosis. This article presents, to our knowledge, the first 2 cases of massive venous thrombosis (1 phlegmasia cerulea dolens, 1 phlegmasia alba dolens) below inferior vena cava filters occurring after the acute period. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Phlegmasia cerulea dolens and phlegmasia alba dolens have high morbidity and mortality. The patient with phlegmasia alba dolens required leg and thigh fasciotomies and eventually required an above-knee amputation. The patient with phlegmasia cerulea dolens developed compartment syndrome in the left leg, right leg, and right thigh. Although he underwent decompression of all of these compartments, he died from multiple organ failure. A multidisciplinary approach with the vascular service and the intensivists is required in the treatment of patients with massive venous thrombosis. Treatment goals include preventing additional propagation of the thrombus via anticoagulation, with strong consideration for catheter-directed thrombolysis or thrombectomy and fasciotomies for compartment syndrome. The orthopedic surgeon should keep phlegmasia cerulea dolens and phlegmasia alba dolens in the differential for compartment syndrome, especially in patients who have had a history of acute or chronic inferior vena cava filter placement.

  18. Anomalous pulmonary venous return: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gyeong Min; Kang, MinJin; Lee, Han Bee; Bae, Kyung Eun; Lee, Jaehe; Kim, Jae Hyung; Jeong, Myeong Ja; Kang, Tae Kyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Partial anomalous pulmonary venous return is a type of congenital pulmonary venous anomaly. We present a rare type of partial pulmonary venous return, subaortic vertical vein drains left lung to superior vena cava, accompanying hypoplasia of the ipsilateral lung and pulmonary artery. We also review the previous report and relationship of these structures.

  19. The expression of matrix metalloproteinase-9 in the chronic venous ulcer tissues and significance%基质金属蛋白酶-9在静脉性溃疡组织中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    杨帆; 李金朋; 王勇

    2016-01-01

    Objective To observe the expression of matrix metalloproteinase-9 (MMP-9) in the tissues of venous ulcer,and to explore the pathological mechanism of angiogenesis dysfunction.Methods Sixty-four ulcer samples were obtained from the patients [(56.27 ± 5.12) years old] including 52 males and 12 females with lower extremity venous ulcer treated in our hospital.The ulcer samples were divided into 2-,3-,4-,and 5-week groups based on the course of the disease,and 50 cases of traumatic ulcer [(54.42 ±6.87) years old] served as the contol group.The expression of MMP-9,and vascular endothelial growth factor receptor 2 (VEGFR2) was analyzed by Western blotting and grey ratio detection.The immunofluorescence double staining was used to observe the correlation of MMP-9/CD31 expression.Results There was significant difference in the grey ratio detection of MMP-9 between 4-,and 5-week groups with 2-,3-week groups (0.181 ± 0.031,0.007 ± 0.014 vs.0.512 ± 0.113,0.685 ± 0.174);VEGFR2 between 4-,and 5-week groups and 3-week group (0.614 ± 0.143,0.497 ± 0.262 vs.1.465 ± 0.074,P < 0.05).Immunofluorescence double staining revealed that the levels of MMP-9/CD31 was also markedly decreased in the venous ulcer group as compared with those in traumatic ulcer group,and the correlation was observed.Conclusion The low expression of VEGFR2 that is regulated by MMP-9 possibly is associated with angiogenesis dysfunction in the tissues of venous ulcer.%目的 观察静脉性溃疡组织中的基质金属蛋白酶-9(MMP-9)表达,探讨静脉性溃疡血管再生障碍机制.方法 采集我院64例静脉性溃疡患者溃疡创面标本,其中男52例,女12例,平均年龄(56.27±5.12)岁,按病程分为2周组、3周组、4周组、5周组,以创伤性溃疡50例作为对照组,平均年龄(54.42±6.87)岁,Western blot检测各组溃疡创面MMP-9、血管内皮生长因子受体2(VEGFR2)表达趋势;用免疫荧光双染色检测MMP-9/CD31在溃疡组

  20. Prophylaxis of Venous Thrombosis in Neurocritical Care Patients: An Evidence-Based Guideline: A Statement for Healthcare Professionals from the Neurocritical Care Society.

    Science.gov (United States)

    Nyquist, Paul; Bautista, Cynthia; Jichici, Draga; Burns, Joseph; Chhangani, Sanjeev; DeFilippis, Michele; Goldenberg, Fernando D; Kim, Keri; Liu-DeRyke, Xi; Mack, William; Meyer, Kim

    2016-02-01

    The risk of death from venous thromboembolism (VTE) is high in intensive care unit patients with neurological diagnoses. This is due to an increased risk of venous stasis secondary to paralysis as well as an increased prevalence of underlying pathologies that cause endothelial activation and create an increased risk of embolus formation. In many of these diseases, there is an associated risk from bleeding because of standard VTE prophylaxis. There is a paucity of prospective studies examining different VTE prophylaxis strategies in the neurologically ill. The lack of a solid evidentiary base has posed challenges for the establishment of consistent and evidence-based clinical practice standards. In response to this need for guidance, the Neurocritical Care Society set out to develop and evidence-based guideline using GRADE to safely reduce VTE and its associated complications.

  1. Metástasis en hueso maxilar superior de adenocarcinoma de esófago: presentación de un caso clínico

    OpenAIRE

    Sánchez Jiménez, Juan; Acebal Blanco, Faustino; Arévalo Arévalo, Rafael; Molina Martínez, Manuel

    2005-01-01

    Las metástasis en cavidad oral son lesiones raras que representan aproximadamente el 1% de todas las neoplasias malignas de cavidad oral. Las metástasis orales se localizan en un 80-90% en mandíbula, siendo mas raras en maxilar superior. Las metástasis en tejidos blandos de boca son raras, y es encía donde con mayor frecuencia se localizan las metástasis en tejidos blandos en boca. Los tumores primarios que metastatizan a boca son los más frecuentes pulmón, mama y riñón. ...

  2. Endovascular treatment options in the management of lower limb deep venous thrombosis.

    Science.gov (United States)

    Nazir, Sarfraz Ahmed; Ganeshan, Arul; Nazir, Sheraz; Uberoi, Raman

    2009-09-01

    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.

  3. Association between venous leg ulcers and sex chromosome anomalies in men.

    Science.gov (United States)

    Gattringer, Cornelia; Scheurecker, Christine; Höpfl, Reinhard; Müller, Hansgeorg

    2010-11-01

    We report here two cases of men, aged 46 and 23 years, with refractory chronic venous leg ulcers in association with sex chromosome aberrations: one with a 47,XXY/48,XXXY karyotype (Klinefelter syndrome) and the other with a 47,XYY karyotype (Jacob syndrome). In both patients, the occurrence of leg ulcers was the reason for seeking medical care; their medical history was other-wise unremarkable. Chromosomal analyses were performed due to the unusually young age for development of venous leg ulcers. The pathophysiology behind the occurrence of venous leg ulcers in patients with numerical aberrations of the sex chromosomes is incompletely understood. Involvement of elevated plasminogen activator inhibitor-1 levels in the pathogenesis of venous leg ulcers has been reported in patients with Klinefelter syndrome. Notably, our patient with 47,XXY/48,XXXY presented with androgen deficiency but normal plasminogen activator inhibitor-1 activity.

  4. 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

  5. Venous thrombosis : a patient's view

    NARCIS (Netherlands)

    Korlaar, Inez van

    2006-01-01

    The studies described in this thesis had two main aims: 1) To study the quality of life of patients with venous thrombosis and to examine the role of illness perceptions in explaining the quality of life of these patients. 2) To assess the psychological consequences of genetic testing for thrombop

  6. Venous thromboembolic disease. CT evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Goodman, L. R. [Medical College of Wisconsin, Pulmonary Medicine and Intensive Care, Dept. of Diagnostic Radiology, Milwaukee, WI (United States)

    2001-12-01

    Helical and multidetector CT has proven to be a valuable imaging modality for both pulmonary embolism and deep venous thrombosis. This paper will review the sensitivity and specificity of CT and discuss diagnostic algorithms utilizing CT and more established imaging technologies.

  7. Imaging Diagnosis of Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    S. Rajesh

    2015-01-01

    Full Text Available Splanchnic vein thrombosis (SVT is a broad term that includes Budd-Chiari syndrome and occlusion of veins that constitute the portal venous system. Due to the common risk factors involved in the pathogenesis of these clinically distinct disorders, concurrent involvement of two different regions is quite common. In acute and subacute SVT, the symptoms may overlap with a variety of other abdominal emergencies while in chronic SVT, the extent of portal hypertension and its attendant complications determine the clinical course. As a result, clinical diagnosis is often difficult and is frequently reliant on imaging. Tremendous improvements in vascular imaging in recent years have ensured that this once rare entity is being increasingly detected. Treatment of acute SVT requires immediate anticoagulation. Transcatheter thrombolysis or transjugular intrahepatic portosystemic shunt is used in the event of clinical deterioration. In cases with peritonitis, immediate laparotomy and bowel resection may be required for irreversible bowel ischemia. In chronic SVT, the underlying cause should be identified and treated. The imaging manifestations of the clinical syndromes resulting from SVT are comprehensively discussed here along with a brief review of the relevant clinical features and therapeutic approach.

  8. 3种不同血瘀证动物模型的建立与评价%The establishment and evaluation of three different kinds of animal model of blood stasis syndrome

    Institute of Scientific and Technical Information of China (English)

    梁耀月; 李佳佳; 董世芬; 张荣; 袁悦莹; 孙建宁

    2016-01-01

    目的:建立痰浊血瘀、气滞血瘀、痰浊+气滞血瘀大鼠模型,研究不同血瘀状态动物模型的特征。方法选用SD大鼠,随机分为正常对照组、高脂饲料组、慢性刺激组( chro-nic unpredictable mild stress,CUMS)、高脂饲料+慢性刺激组,分别采用相应因素干预6周。于2、4、6周动态监测动物体重、旷场行为、血脂和血清皮质酮指标;实验终点(6周)采用小动物超声和左心室插管法检测心功能,采用黏度仪、红细胞变形/聚集测试仪检测血液流变性相关指标。结果与正常对照组大鼠相比,采用高脂饲料、慢性不可预知性刺激后均可引起血瘀状态,对动物的行为学、血脂、心脏功能、血液黏度造成了不同程度的影响,当两因素叠加时,血瘀相关指标变化最明显,表现为:与正常对照组比较,体重明显降低(P<0.01),2周时水平运动、垂直运动、运动时间均减少(P<0.01或 P <0.05),2周、4周时,血清皮质酮上升( P <0.01或P<0.05),4周、6周时TG明显上升(P<0.01)。6周时,血流速度减慢(P<0.01),收缩末期左室前壁、后壁厚度均增厚(P<0.01或P<0.05),舒张期左心室指数上升(P<0.01),左心室最大收缩速率降低(P<0.05),全血黏度上升(P<0.01)。结论高脂饲料喂养和慢性不可预知性刺激均可形成血瘀状态,但是具有不同的特点。当两因素叠加时,动物可明显出现行为学、血液黏度、心脏功能、血脂等指标的异常,可为血瘀证以及相关药物的研究提供依据。%Aim To establish phlegm and blood stasis, qi-stag-nation and blood stasis, phlegm turbid+qi-stagnation and blood stasis model in rats and to study the characteristics of animal models with different blood stasis. Methods SD rats were ran-domly divided into normal group, high fat diet group, chronic unpredictable mild stress group ( CUMS ) and high fat diet +chronic unpredictable mild stress group. Different states

  9. 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.

  10. Cerebral venous circulatory disturbance as an informative prognostic marker for neonatal hemorrhagic stroke

    Science.gov (United States)

    Semyachkina-Glushkovskaya, Oxana; Pavlov, Alexey; Navolokin, Nikita; Lychagov, Vladislav; Abdurashitov, Arkady; Zinchenko, Ekaterina; Gekaluk, Artemiy; Zhu, Dan; Shi, Rui; Luo, Qingming; Tuchin, Valery

    2016-04-01

    Neonatal hemorrhagic stroke (NHS) is a major problem of future generation's health due to the high rate of death and cognitive disability of newborns after NHS. The incidence of NHS in neonates cannot be predicted by standard diagnostic methods. Therefore, the identification of prognostic markers of NHS is crucial. There is evidence that stress-related alterations of cerebral blood flow (CBF) may contribute to NHS. Here, we assessed the stroke-associated CBF abnormalities for high prognosis of NHS using a new model of NHS induced by sound stress in the pre- and post-stroke state. With this aim, we used interdisciplinary methods such as a histological assay of brain tissues, laser speckle contrast imaging and Doppler coherent tomography to monitor cerebral circulation. Our results suggest that the venous stasis with such symptoms as progressive relaxation of cerebral veins, decrease the velocity of blood flow in them are prognostic markers for a risk of NHS and are an informative platform for a future study of corrections of cerebral venous circulatory disturbance related to NHS.

  11. 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.

  12. Metástasis cutáneas de cáncer de recto

    Directory of Open Access Journals (Sweden)

    M.J. de Miguel Valencia

    2013-12-01

    Full Text Available El carcinoma colorrectal es un tumor que con muy poca frecuencia origina metástasis cutáneas, y cuando lo hace raramente es por vía hematógena. Presentamos el caso de un varón de 55 años diagnosticado de un adenocarcinoma de recto (tercio inferior estadio T3N2M0. Tratado inicialmente con radioquimioterapia neoadyuvante, fue intervenido ocho semanas después realizándose una amputación abdominoperineal extendida. El resultado anatomopatológico fue de adenocarcinoma mucinoso de recto, estadio ypT3bN1. Tras un postoperatorio sin complicaciones el paciente recibió tratamiento quimioterápico con capecitabina. A los 18 meses el paciente refirió la aparición progresiva de nódulos subcutáneos en distintas localizaciones. En la tomografía computarizada de control se objetivaron múltiples imágenes sugestivas de metástasis a nivel hepático y pulmonar, así como lesiones subcutáneas. La exéresis-biopsia de uno de los nódulos subcutáneos corroboró la sospecha de metástasis de adenocarcinoma de recto. Se valoró tratamiento quimioterápico que no llegó a administrarse por el rápido deterioro del paciente que llevó al exitus.

  13. 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.

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

    Science.gov (United States)

    Becknell, Brian; Mohamed, Ahmad Z.; Li, Birong; Wilhide, Michael E.; Ingraham, Susan E.

    2015-01-01

    Purpose 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. Methods 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. Results 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. Conclusions CONS is an opportunistic uropathogen in the setting of urinary stasis, leading to enhanced UTI incidence and severity in Mgb-/- mice. PMID:26401845

  15. Fossilized nuclei and chromosomes reveal 180 million years of genomic stasis in royal ferns.

    Science.gov (United States)

    Bomfleur, Benjamin; McLoughlin, Stephen; Vajda, Vivi

    2014-03-21

    Rapidly permineralized fossils can provide exceptional insights into the evolution of life over geological time. Here, we present an exquisitely preserved, calcified stem of a royal fern (Osmundaceae) from Early Jurassic lahar deposits of Sweden in which authigenic mineral precipitation from hydrothermal brines occurred so rapidly that it preserved cytoplasm, cytosol granules, nuclei, and even chromosomes in various stages of cell division. Morphometric parameters of interphase nuclei match those of extant Osmundaceae, indicating that the genome size of these reputed "living fossils" has remained unchanged over at least 180 million years-a paramount example of evolutionary stasis.

  16. Arquitectura y Música: El Pabellón Philips y Metástasis

    OpenAIRE

    Ferrández Orbezua, Ariadne

    2016-01-01

    La relación entre música y arquitectura ha sido un tema recurrente, ya sea comparando la proporción visual con la armonía sonora o citando, una vez más, aquella frase de Schopenhauer que define a la arquitectura como música congelada. En este trabajo fin de grado se aborda la relación entre la Música y la Arquitectura desde el estudio de dos obras en concreto; la obra musical para orquesta Metástasis del compositor Iannis Xenakis y la obra arquitectónica del Pabellón Philips de Iannis Xenakis...

  17. Metástasis intestinales yeyunales, forma de presentación de un carcinoma pulmonar

    Directory of Open Access Journals (Sweden)

    D. Ruiz-Clavijo García

    2015-04-01

    Full Text Available Los tumores primarios de intestino delgado son muy infrecuentes, siendo todavía más raros los metastásicos. Es excepcional que las metástasis de intestino delgado se manifiesten antes que el tumor primario. La presentación clínica puede requerir una resección quirúrgica intestinal motivada por perforación, hemorragia, obstrucción-suboclusión intestinal e incluso invaginación intestinal. La supervivencia, es escasa y generalmente no supera las 20 semanas, independientemente del tratamiento que se realice.

  18. Clinical aspects of venous thrombophilia.

    Science.gov (United States)

    Girolami, Antonio; Fabris, Fabrizio; Girolami, Bruno

    2002-01-01

    Venous thrombophilia is the result of clotting changes namely of a hypercoagulable state together with blood flow and vessel wall changes. There is no need for all these components to be present in order for thrombosis to occur. As the matter of fact, thrombosis may occur even if only one of these conditions is present. In clinical practice a combination of factors is usualy seen. In comparison with arterial thrombophilia, clotting changes and blood flow seen to play a major role in venous thrombosis. Venous thrombophilia may remain asynptomatic or may result in a series of clinical syndromes. The commonest of these are: 1. Superficial vein thrombosis, 2. Deep vein thrombosis of legs, 3. Deep vein thrombosis of arms, 4. Caval veins thrombosis, 5. Portal vein thrombosis, 6. Hepatic veins thrombosis, 7. Renal vein thrombosis, 8. Cerebral sinuses thrombosis, 9. Right heart thrombosis, 10. Miscellaneous (ovarian, adrenal veins thrombosis, etc.). Since the first two are widely and easily recognized, these is no need for an extensive discussion. Deep vein thromboses of upper limbs are not as frequent as those of lower limbs or of superficial phlebitis but they can still be recognized on clinical grounds and non invasive techniques. The remaining 7 syndromes are less common and therefore less frequently suspected and recognized. Of particular interest, among these less common manifestations of venous thrombophilia are hepatic vein and renal vein thrombosis. Hepatic veins thrombosis, sometimes part of inferior vena cava thrombosis is most frequently due to an isolated occlusion of hepatic veins thereby causing a form of venocclusive disease. Occasionally diagnosis may be difficult because of slow onset of symptoms (hepatomegaly, right flank pain, fever, ascites etc.). The same is true for renal vein thrombosis which may also be of difficult diagnosis since it causes proteinuria and flank pain. The proteinuria is often interpreted as due to a nephrotic syndrome which

  19. 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.

  20. Mixed Capillary Venous Retroperitoneal Hemangioma

    Directory of Open Access Journals (Sweden)

    Mohit Godar

    2013-01-01

    Full Text Available We report a case of mixed capillary venous hemangioma of the retroperitoneum in a 61-year-old man. Abdominal ultrasonography showed a mass to be hypoechoic with increased flow in color Doppler imaging. Dynamic contrast-enhanced computed tomography revealed a centripetal filling-in of the mass, located anterior to the left psoas muscle at the level of sacroiliac joint. On the basis of imaging features, preoperative diagnosis of hemangioma was considered and the mass was excised by laparoscopic method. Immunohistochemical studies were strongly positive for CD31 and CD34, and negative for calretinin, EMA, WT1, HMB45, Ki67, synaptophysin, and lymphatic endothelial cell marker D2–40. Histologically, the neoplasm was diagnosed as mixed capillary venous hemangioma.

  1. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombos

    NARCIS (Netherlands)

    Tick, L.W.; Kramer, M.H.H.; Rosendaal, F.R.; Faber, W.R.; Doggen, C.J.M.

    2008-01-01

    Background: Post-thrombotic syndrome (PTS) is a chronic complication of deep venous thrombosis (DVT). Objectives: To determine the risk of PTS after DVT and to assess risk factors for PTS. Methods: Patients were recruited from the Multiple Environmental and Genetic Assessment (MEGA) study of risk fa

  2. Deliberative Rhetoric and Forensic Stasis: Reconsidering the Scope and Function of an Ancient Rhetorical Heuristic in the Aftermath of the Thomas/Hill Controversy.

    Science.gov (United States)

    Pullman, George L.

    1995-01-01

    Examines the second confirmation hearing of Judge Clarence Thomas as it concerned the reception of Professor Anita Hill's comments. Argues that the application of forensic stasis in a situation where the evidence could not fit the forensic pattern virtually guaranteed the confirmation of Judge Clarence Thomas. Suggests that forensic stasis is not…

  3. Hydrocephalus in cerebral venous thrombosis.

    Science.gov (United States)

    Zuurbier, Susanna M; van den Berg, René; Troost, Dirk; Majoie, Charles B; Stam, Jan; Coutinho, Jonathan M

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and 2010 (prospectively since July 2006). Hydrocephalus was defined as a bicaudate index larger than the 95th percentile for age, and/or a radial width of the temporal horn of ≥ 5 mm. We excluded patients in whom hydrocephalus was caused by a disease other than CVT or if it was iatrogenic. 20 out of 99 patients with CVT had hydrocephalus. 6 patients with hydrocephalus were excluded from the analysis. Patients with hydrocephalus more often had focal neurological deficits (86 vs. 49%, p = 0.02) and were more frequently comatose (43 vs. 16%, p = 0.06), as compared to patients without hydrocephalus. Deep cerebral venous thrombosis (64 vs. 9%, p hydrocephalus. Intraventricular hemorrhage was present in 1 patient with hydrocephalus, compared to none among patients without hydrocephalus (7 vs. 0%, p = 0.15). Outcome at follow-up was worse in patients with hydrocephalus (mRS 0-1, 36 vs. 68%, p = 0.02; mortality 29 vs. 9%, p = 0.07). Hydrocephalus occurs more frequently in cerebral venous thrombosis than previously believed, especially in patients with deep cerebral venous thrombosis and edema of the basal ganglia. The presence of hydrocephalus is associated with a worse clinical outcome, but a direct causal relation is unlikely. Routine shunting procedures are not advisable.

  4. 从瘀论治黄褐斑临证心得%Clinical Experience of Chloasma Treatment From Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    王正; 吴元洁; 吴广铮

    2011-01-01

    By combining with the traditional theory, the clinical features and western pathogenesis of melasma, the authors elaborate the pathogenesis of melasma associated with the blood stasis, and describe clinical experience in treating melasma by activating blood and resolving stasis.%作者结合黄褐斑的传统理论、发病特点及西医发病机制,阐述了黄褐斑与血瘀病机的相关性,并介绍了活血化瘀治疗黄褐斑的临床经验.

  5. 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.

  6. Metástasis humeral tardía de un cáncer de laringe

    OpenAIRE

    Martínez Martín, Angel Antonio; Vera Alvarez, J.; Sanz Lacalle, Javier; Cuadra Ruiz, J.; Gracia Repollés, Fernando

    1999-01-01

    Presentamos un caso de metástasis ósea única en el húmero cuyo tumor primario fue un cáncer de laringe. Investigamos otras localizaciones primarias pero sólo se encontró esta. La metástasis apareció 6 años después de que el tumor primario fuera detectado. El diagnóstico fue confirmado mediante biopsia. El paciente fue tratado mediante radioterapia local, obteniéndose un alivio de su dolor. We report a case of solitary bone metastasis in the humerus whose primaty tumor was a larynx cancer. ...

  7. 原发性青光眼与血瘀关系%Relation Between Primary Glaucoma and Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    李翔; 黄江丽; 王超

    2013-01-01

    It discussed relationship between primary glaucoma and blood stasis by the primary glaucoma pathogenesis, clinical manifestations and treatment, providing some reference for treating glaucoma with method of activating blood circulation and resolving stasis.%本文从原发性青光眼发病机制、临床表现和治疗等方面探讨原发性青光眼与“血瘀”的关系,为临床应用活血化瘀治疗青光眼提供参考.

  8. A technique for re-utilizing catheter insertion sites in children with difficult central venous access.

    Science.gov (United States)

    Johnson, S M; Garnett, G M; Woo, R K

    2017-01-01

    Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down." A separate exit site is then created for the new catheter and it is tunneled to the "cut-down" site per routine. The non-functioning catheter is then removed from the surgical field. The proximal fibrous sheath is finally cannulated either directly with the new catheter or with a wire/dilator system. This technique effectively re-uses the same venous access point while allowing for a complete change of the physical line and external site. Twenty attempts at this technique were made in twelve patients; six patients underwent the site re-utilization procedure multiple times. Re-using the fibrous tunnel to re-cycle the internal catheter site was successful in seventeen of twenty attempts. All patients had chronic conditions leading to difficult long-term central venous access [short bowel syndrome (6), hemophilia (2), cystic fibrosis (1), chronic need for central IV access (3)]. Indications for catheter replacement included catheter occlusion/mechanical failure/breakage (9), dislodgement (6), infection (1), and inadequate catheter length due to patient growth (4). Broviac/Hickman catheter sites were most commonly re-used (13; one failure); re-using a portcath site was successful in 5 of 7 attempts. There were no short term infections or mechanical complications. We describe a novel technique for salvaging tunneled central venous catheter access sites. This technique is well suited

  9. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Science.gov (United States)

    Moualla, Maan

    2016-01-01

    Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism. PMID:28050169

  10. A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Peter V. Bui

    2016-01-01

    Full Text Available Introduction. 3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism. Case Presentation. A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity. Discussion. As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism.

  11. Ruptured venous aneurysm of cervicomedullary junction

    Directory of Open Access Journals (Sweden)

    Ashish Aggarwal

    2014-01-01

    Full Text Available Background: Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM or developmental venous anomaly (DVA. However, isolated venous aneurysm is unusual. Case Description: We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH and intraventricular hemorrhage (IVH. Digital substraction angiography (DSA revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ. Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 Χ 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein. Conclusion: This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

  12. 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.

  13. Iliofemoral and iliocaval interventions in deep venous thrombosis; Iliofemorale und iliocavale Interventionen bei tiefer Venenthrombose

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Guenther, R.W. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen (Germany)

    2005-05-01

    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 postthrombotic 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.)

  14. 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.

  15. Venous thromboembolism at uncommon sites in neonates and children.

    Science.gov (United States)

    Pergantou, Helen; Avgeri, Maria; Komitopoulou, Anna; Xafaki, Panagiota; Kapsimali, Zoey; Mazarakis, Michail; Adamtziki, Eftychia; Platokouki, Helen

    2014-11-01

    We retrospectively analyzed the data of 24 children (whereof 11 neonates), with non-central venous line-related and nonmalignancy-related venous thromboembolism (VTE) at uncommon sites, referred to our Unit from January 1999 to January 2012. Thirty patients who also suffered deep vein thrombosis, but in upper/low extremities, were not included in the analysis. The location of rare site VTE was: portal (n=7), mesenteric (n=2) and left facial vein (n=1), spleen (n=3), lung (n=3), whereas 10 neonates developed renal venous thrombosis. The majority of patients (91.7%) had at least 1 risk factor for thrombosis. Identified thrombophilic factors were: antiphospholipid antibodies (n=2), FV Leiden heterozygosity (n=6), MTHFR C677T homozygosity (n=4), protein S deficiency (n=2), whereas all neonates had age-related low levels of protein C and protein S. All but 6 patients received low-molecular-weight heparin, followed by warfarin in 55% of cases, for 3 to 6 months. Prolonged anticoagulation was applied in selected cases. During a median follow-up period of 6 years, the clinical outcome was: full recovery in 15 patients, evolution to both chronic portal hypertension and esophageal varices in 2 children, and progression to renal failure in 7 of 10 neonates. Neonates are greatly vulnerable to complications after VTE at uncommon sites, particularly renal. Future multicentre long-term studies on neonatal and pediatric VTE at unusual sites are considered worthwhile.

  16. Transpleural central venous catheter discovered during thoracotomy

    Directory of Open Access Journals (Sweden)

    Ashima Malhotra

    2014-01-01

    Full Text Available 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 secured surgically.

  17. Central venous line complications and tip detection

    Directory of Open Access Journals (Sweden)

    Ameneh Rezaee Gheshlaghi

    2015-06-01

    Full Text Available Central venous line is one of a creative instrument that saves human’s life in critical medical situation. Central venous line access is frequently involved in the disease management. It is used for rapid fluid therapy, transvenous pacemakers, infusion of some medications, hemodialysis or plasmapheresis and etc. Most of the emergency departments have some staffs that are trained for central venous line insertion but related complications occur during central venous line placement.Central venous line might have some complications and complication follow-up should be considered. Thromboembolism and infection are two important medical complications. Arterial puncture, hematoma, pneumothorax and hemothorax are mechanical Central venous line complications. Chest X-ray and some other techniques should be used for detecting these complications.Central venous line tip misplace is a considerable problem for emergency department staffs, previously chest X-ray has been used for central venous line misplace detection. In some recent studies, contrast-enhanced ultrasonography and intravascular electrocardiography have been used for central venous line misplace.

  18. Characterizing the Risk Factors Associated With Venous Thromboembolism in Pediatric Patients After Central Venous Line Placement

    OpenAIRE

    Wisecup, Sarah; Eades, Shannan; Turiy, Yuliya

    2015-01-01

    OBJECTIVES: With the apparent increase in venous thromboembolism noted in the pediatric population, it is important to define which children are at risk for clots and to determine optimal preventative therapy. The purpose of this study was to determine the risk factors for venous thromboembolism in pediatric patients with central venous line placement.

  19. 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.

  20. Chronic Meningitis Complicating Intracranial Hypertension in Neurobrucellosis: A Case Report.

    Science.gov (United States)

    Tugcu, Betul; Nacaroglu, Senay Asik; Coskun, Cigdem; Kuscu, Demet Yandım; Onder, Feyza

    2015-01-01

    In neurobrucellosis, even though meningitis is encountered frequently, chronic intracranial hypertension is a rare manifestation. Early diagnosis and treatment is very important for the prevention of permanent visual loss secondary to poststasis optic atrophy in these cases. We report a case that presented with permanent visual loss secondary to intracranial hypertension in neurobrucellosis. Our goal is to draw attention to the consideration of neurobrucellosis in cases with papilla stasis, even in the absence of neurological findings in endemic areas.

  1. 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...... with IBD have a high risk of venous thromboembolism especially during IBD flare-ups. Their risk of arterial cardiovascular disease may also be increased. The risk of cardiovascular disease in patients with IBD warrants clinical attention, and it is possible that the risk can be modified by applying anti...

  2. The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism.

    Science.gov (United States)

    Jaffray, Julie; Bauman, Mary; Massicotte, Patti

    2017-01-01

    The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs. non-tunneled vs. peripherally inserted vs. implanted), catheter material, insertion technique, or insertion location lead to an increased VTE risk. The patient populations who were found to be most at risk for CVC-VTE were those with cancer, congenital heart disease, gastrointestinal failure, systemic infection, intensive care unit admission, or involved in a trauma. Both mechanical and pharmacological prophylactic techniques have been shown to be successful in preventing VTE in adult patients, but studies in children have yet to be performed or are underpowered. In order to better determine true CVC-VTE risk factors and best preventative techniques, an increase in large, prospective pediatric trials needs to be performed.

  3. The Impact of Central Venous Catheters on Pediatric Venous Thromboembolism

    Science.gov (United States)

    Jaffray, Julie; Bauman, Mary; Massicotte, Patti

    2017-01-01

    The use of central venous catheters (CVCs) in children is escalating, which is likely linked to the increased incidence of pediatric venous thromboembolism (VTE). In order to better understand the specific risk factors associated with CVC-VTE in children, as well as available prevention methods, a literature review was performed. The overall incidence of CVC-VTE was found to range from 0 to 74%, depending on the patient population, CVC type, imaging modality, and study design. Throughout the available literature, there was not a consistent determination regarding whether a particular type of central line (tunneled vs. non-tunneled vs. peripherally inserted vs. implanted), catheter material, insertion technique, or insertion location lead to an increased VTE risk. The patient populations who were found to be most at risk for CVC-VTE were those with cancer, congenital heart disease, gastrointestinal failure, systemic infection, intensive care unit admission, or involved in a trauma. Both mechanical and pharmacological prophylactic techniques have been shown to be successful in preventing VTE in adult patients, but studies in children have yet to be performed or are underpowered. In order to better determine true CVC-VTE risk factors and best preventative techniques, an increase in large, prospective pediatric trials needs to be performed. PMID:28168186

  4. Risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease combined with deep venous thrombosis%慢性阻塞性肺疾病急性加重期合并深静脉血栓形成危险因素及抗凝因子检测

    Institute of Scientific and Technical Information of China (English)

    孙建英; 刘飒; 王红阳; 刘晨; 刘新茹; 贾红光

    2010-01-01

    Objective To investigate the risk factors and anticoagulation parameters in patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with deep venous thrombosis (DVT). Methods All of 110 AECOPD patients were divided into two groups according to Doppler examination of lower extremities: DVT group and non-DVT group. The risk factors and anticoagulation parameters were compared. Results Twelve cases (10.9%) were in DVT group,of whom 2 cases (1.8%)had pulmonary embolism. The rate of lying in bed > 3 d, smoke, mechanical ventilation, hospital stays and the levels of PaCO2 were significantly higher in DVT group than those in non-DVT group (P 3 d、吸烟、机械通气的例数增多及住院时间延长(P<0.01),动脉血二氧化碳分压(PaCO2)增高(P<0.05);抗凝血酶Ⅲ活性、蛋白S含量下降(P<0.05)及血D-二聚体含量增加(P<0.05).结论 造成AECOPD患者制动的因素如长期卧床及吸烟、机械通气是发生DVT的高危因素;且Ⅱ型呼吸衰竭的患者更容易合并DVT;AECOPD合并DVT患者存在纤溶功能失衡状态,应监测纤溶指标变化.

  5. Biofilms in chronic wounds.

    Science.gov (United States)

    James, Garth A; Swogger, Ellen; Wolcott, Randall; Pulcini, Elinor deLancey; Secor, Patrick; Sestrich, Jennifer; Costerton, John W; Stewart, Philip S

    2008-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  6. 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。

  7. Metástasis hipofisaria de carcinoma de mama debutando como diabetes insípida

    Directory of Open Access Journals (Sweden)

    Ana Arévalo

    2012-03-01

    Full Text Available Los tumores metastáticos que afectan a la glándula hipofisaria son hallazgos pocos comunes, presentándose en cerca del 1% de las cirugías hipofisarias. Los autores presentan el caso de una paciente mujer de 46 años que debuta con síntomas de diabetes insípida. Había sido tratada 3 años antes por un carcinoma ductal infiltrante de la mama derecha. Las imágenes de resonancia magnética cerebral mostraron una masa en la silla turca con extensión supraselar. La paciente fue sometida a resección tumoral vía transesfenoidal que demostró metástasis de carcinoma de mama.

  8. 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

  9. Sex-specific aspects of venous thrombosis

    NARCIS (Netherlands)

    Roach, Rachel Elizabeth Jo

    2014-01-01

    Venous thrombosis is a disease that occurs in 1-2 per 1000 people per year. At the time of their first venous thrombosis, approximately 50% of women are exposed to reproductive risk factors (oral contraception, postmenopausal hormone therapy, pregnancy and the puerperium). In this thesis, we showed

  10. U turn to venous air embolism

    Directory of Open Access Journals (Sweden)

    Singh Harsimran

    2009-01-01

    Full Text Available There is a definitive risk of venous air embolism when the fluid infusion is complete and the drip set is still open in a glass bottle.We have devised a novel way of preventing the chances of air embolism when the fluid in the glass bottle finishes. It really gives a "U" turn to the chances of venous air embolism.

  11. Developmental Venous Anomaly: Benign or Not Benign

    Science.gov (United States)

    AOKI, Rie; SRIVATANAKUL, Kittipong

    2016-01-01

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes. PMID:27250700

  12. An unusual Complication of Central Venous Cannulation

    Directory of Open Access Journals (Sweden)

    Ashvini Kumar

    2013-04-01

    Full Text Available Central venous catheter (CVC hub fracture is a rare complication of central venous cannulation. We report a case where catheter hub fracture was detected immediately after CVC insertion. Causes of catheter hub fracture and its complications are discussed.

  13. Risk factors for venous thromboembolism during pregnancy

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo; Gerds, Thomas Alexander; Grøn, Randi;

    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....

  14. 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.

  15. 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.

  16. 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.

  17. 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.

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

    Science.gov (United States)

    Miller, Charne; Kapp, Suzanne; Donohue, Lisa

    2014-01-01

    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. PMID:27429280

  19. 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

  20. Advanced management of acute iliofemoral deep venous thrombosis: emergency department and beyond.

    Science.gov (United States)

    Pollack, Charles V

    2011-06-01

    Recent attention to the increasing incidence of venous thromboembolism has included a call to action from the surgeon general and new guidelines from various specialty organizations. The standard of care for treatment of deep venous thrombosis in the emergency department (ED), supported by the 2008 American College of Chest Physicians (ACCP) guidelines, involves initiation of anticoagulation with low-molecular-weight heparin, pentasaccharide, or unfractionated heparin. For selected appropriate patients with extensive acute proximal deep venous thrombosis, the ACCP guidelines now recommend thrombolysis in addition to anticoagulation to reduce not only the risk of pulmonary embolism but also the risk of subsequent postthrombotic syndrome and recurrent deep venous thrombosis. Postthrombotic syndrome is a potentially debilitating chronic cluster of lower-extremity symptoms occurring in 20% to 50% of deep venous thrombosis patients subsequent to the acute insult, sometimes not until years later. A strategy of early thrombus burden reduction or frank removal might reduce the incidence of postthrombotic syndrome, as per natural history studies, venous thrombectomy data, observations after systemic and catheter-directed thrombolysis, and the still-limited number of randomized trials of catheter-directed thrombolysis (with anticoagulation) versus anticoagulation alone. Contemporary invasive (endovascular) treatments mitigate the drawbacks historically associated with thrombolytic approaches by means of intrathrombus delivery of drugs with greater fibrin specificity and lower allergenicity, followed by mechanical dispersion to accelerate lysis and then aspiration of remaining drug and clot debris. With a 2016 target completion date, the National Heart, Lung, and Blood Institute--sponsored Acute Venous Thrombosis: Thrombus Removal With Adjunctive Catheter-Directed Thrombolysis trial is comparing the safety and efficacy, in terms of both deep venous thrombosis and

  1. Combined therapy of Ulmo honey (Eucryphia cordifolia and ascorbic acid to treat venous ulcers

    Directory of Open Access Journals (Sweden)

    Mariano del Sol Calderon

    2015-04-01

    Full Text Available OBJECTIVE: to assess the clinical effect of topical treatment using Ulmo honey associated with oral ascorbic acid in patients with venous ulcers. METHOD: longitudinal and descriptive quantitative study. During one year, 18 patients were assessed who were clinically diagnosed with venous ulcer in different stages, male and female, adult, with a mean injury time of 13 months. Ulmo honey was topically applied daily. The dressing was applied in accordance with the technical standard for advanced dressings, combined with the daily oral consumptions of 500 mg of ascorbic acid. The monitoring instrument is the assessment table of venous ulcers. RESULTS: full healing was achieved in 100% of the venous ulcers. No signs of complications were observed, such as allergies or infection. CONCLUSION: the proposed treatment showed excellent clinical results for the healing of venous ulcers. The honey demonstrated debriding and non-adherent properties, was easy to apply and remove and was well accepted by the users. The described results generated a research line on chronic wound treatment.

  2. Cerebral venous outflow and cerebrospinal fluid dynamics

    Directory of Open Access Journals (Sweden)

    Clive B. Beggs

    2014-12-01

    Full Text Available In this review, the impact of restricted cerebral venous outflow on the biomechanics of the intracranial fluid system is investigated. The cerebral venous drainage system is often viewed simply as a series of collecting vessels channeling blood back to the heart. However there is growing evidence that it plays an important role in regulating the intracranial fluid system. In particular, there appears to be a link between increased cerebrospinal fluid (CSF pulsatility in the Aqueduct of Sylvius and constricted venous outflow. Constricted venous outflow also appears to inhibit absorption of CSF into the superior sagittal sinus. The compliance of the cortical bridging veins appears to be critical to the behaviour of the intracranial fluid system, with abnormalities at this location implicated in normal pressure hydrocephalus. The compliance associated with these vessels appears to be functional in nature and dependent on the free egress of blood out of the cranium via the extracranial venous drainage pathways. Because constricted venous outflow appears to be linked with increased aqueductal CSF pulsatility, it suggests that inhibited venous blood outflow may be altering the compliance of the cortical bridging veins.

  3. Haemoptysis due to pulmonary venous stenosis

    Directory of Open Access Journals (Sweden)

    Silke Braun

    2014-06-01

    Full Text Available Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10–20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe. A review of the literature was performed using the Medline/PubMed database with the terms: “pulmonary venous stenosis”, “pulmonary venous infarction” and “haemoptysis”. Further references from the case reports were considered. 58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis. Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrast-enhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis.

  4. Effects of danshensu on platelet aggregation and thrombosis: in vivo arteriovenous shunt and venous thrombosis models in rats.

    Directory of Open Access Journals (Sweden)

    Chen Yu

    Full Text Available Danshensu, a type of dihydroxyphenyl lactic acid, is one of the most abundant active phenolic acids in the dried root of Salvia miltiorrhizae (Lamiaceae--widely used traditional Chinese medicine. The effects of danshensu on platelet aggregation and thrombus formation in rats were examined using various methods. It was found that danshensu significantly reduced thrombus weight in 2 experimental thrombosis models; dose-dependent inhibition of adenosine diphosphate (ADP and arachidonic acid (AA-induced platelet aggregation occurred in normal and blood stasis-induced rats; Danshensu also significantly mitigated blood viscosity, plasma viscosity and hematocrit levels. Moreover, danshensu significantly inhibited venous thrombosis-induced expression of cyclooxygenases-2 (COX-2 rather than cyclooxygenases-1(COX-1 in the venous walls, down regulated thromboxane B2 (TXB2 and up regulated 6-keto prostaglandin F1α (6-keto-PGF1α, normalizing the TXB2/6-keto-PGF1α ratio. In addition, danshensu did not induce gastric lesions and even had protective effects on aspirin-induced ulcer formation at doses as high as 60 mg/kg. These findings suggest that the antithrombotic and antiplatelet aggregation effects of danshensu are attributed to its highly selective inhibition of COX-2 and ability to normalize the thromboxane A2(TXA2/prostacyclin(PGI2 balance. These findings suggest that danshensu have great prospects in antithrombotic and antiplatelet therapy.

  5. 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

  6. Current perspective of venous thrombosis in the upper extremity

    NARCIS (Netherlands)

    Flinterman, L.E.; Meer, van der F.J.M.; 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

  7. [Ultrasound-guided peripheral venous access].

    Science.gov (United States)

    Fuzier, Régis; Rougé, Pierre; Pierre, Sébastien

    2016-02-01

    International guidelines advocate the use of first-line ultrasound for central venous catheter, particularly for the internal jugular vein. The role of ultrasound in peripheral venous access remains questionable. In some specific situations, such as pediatrics, obesity and patients with poor venous network, problems to cannulate peripheral vein may occur. Success rate of peripheral intravenous access increases with the diameter of the vein and for a depth of the vein between 0.3 and 1.5 cm. The type of puncture (long-axis or short-axis) and the type of catheters have little influence on the success rate. Specific considerations have to be taken concerning infection control.

  8. Current opinion on iliofemoral venous thrombectomy.

    Science.gov (United States)

    Stephens, G L

    1976-02-01

    Iliofemoral venous thrombosis is discussed and a technique of iliofemoral venous thrombectomy is presented. Operative phlebography is recommended. The personal recommendations of leading American vascular surgeons in treating the patient with acute iliofemoral venous thrombosis are presented. I recommend thrombectomy for phlegmasia cerulea dolens, and in previously healthy, young ambulatory patients with phlegmasia alba dolens who are seen within 48 hours following thrombosis and have failed to show clinical improvement after a trial of bed rest, elevation of the lower extremities, and intravenous heparin. The majority of patients seen with phlegmasia alba dolens will best be served with nonoperative treatment.

  9. 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.

  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. 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.

  12. Upper-extremity deep venous thrombosis: a review.

    Science.gov (United States)

    Mai, Cuc; Hunt, Daniel

    2011-05-01

    Upper-extremity deep venous thrombosis is less common than lower-extremity deep venous thrombosis. However, upper-extremity deep venous thrombosis is associated with similar adverse consequences and is becoming more common in patients with complex medical conditions requiring central venous catheters or wires. Although guidelines suggest that this disorder be managed using approaches similar to those for lower-extremity deep venous thrombosis, studies are refining the prognosis and management of upper-extremity deep venous thrombosis. Physicians should be familiar with the diagnostic and treatment considerations for this disease. This review will differentiate between primary and secondary upper-extremity deep venous thromboses; assess the risk factors and clinical sequelae associated with upper-extremity deep venous thrombosis, comparing these with lower-extremity deep venous thrombosis; and describe an approach to treatment and prevention of secondary upper-extremity deep venous thrombosis based on clinical evidence.

  13. 从血瘀论治老年便秘研究进展%The research progress of treating senile constipation from blood stasis

    Institute of Scientific and Technical Information of China (English)

    占新辉; 王微; 符思

    2015-01-01

    老年人多种疾病均与血瘀有关,易被临床忽视,从而影响治疗。通过对近5年有关从血瘀论治老年便秘的文献进行分析,表明血瘀与老年便秘关系密切的结论。瘀血阻于肠道则形成便秘,便秘日久又可伴随血瘀,两者相互影响、相互为病。%Senior citizens have many diseases related to blood stasis, which was often overlooked by clinicians, and thus affected the treatment of the disease. Through analyzing and summarizing of related literature in recent five years of senile constipation treated from blood stasis, we found that the blood stasis is closely linked to senile constipation. Blood stasis in the gut forms constipation, and constipation with the passing of time forms blood stasis in returen. Blood stasis and constipation often influence each other.

  14. 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.

  15. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, D; 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. Short hairpin RNA screen indicates that Klotho beta/FGF19 protein overcomes stasis in human colonic epithelial cells.

    Science.gov (United States)

    Kim, Jinyong; Eskiocak, Ugur; Stadler, Guido; Lou, Zhenjun; Kuro-o, Makoto; Shay, Jerry W; Wright, Woodring E

    2011-12-16

    Normal human colonic epithelial cells (HCECs) are not immortalized by telomerase alone but also require CDK4. Some human cell types growth-arrest due to stress- or aberrant signaling-induced senescence (stasis). Stasis represents the consequences of growth conditions culture that are inadequate to maintain long-term proliferation. Overexpressed CDK4 titers out p16 and allows cells to ignore the growth arrest signals produced by stasis. To identify factors contributing to the inadequate culture environment, we used a 62,000-member shRNA library to knock down factors cooperating with human telomerase reverse transcriptase (hTERT) in the immortalization of HCECs. Knockdown of Klotho gamma (KLG; also known as KLPH and LCTL) allowed hTERT to immortalize HCECs. KLG is one isoform of the Klotho family of factors that coordinate interaction between different FGF ligands and the FGF receptor. We also found that knockdown of KLG induced another member of the Klotho family, Klotho beta (KLB). Induction of KLB was maintained and could activate ERK1/2 in immortalized cells. Supplementation of the culture medium with the KLB ligand FGF19 had a similar effect on hTERT-expressing HCECs as knockdown of KLG regarding both immortalization and down-regulation of the tumor suppressor Klotho alpha. Together, these data suggest that KLB is an important regulator in the immortalization of HCECs by facilitating FGF19 growth factor signaling.

  17. Links between arterial and venous disease.

    Science.gov (United States)

    Prandoni, P

    2007-09-01

    An increasing body of evidence suggests the likelihood of a link between arterial and venous disease. According to the results of recent studies, atherosclerosis and venous thromboembolism (VTE) share common risk factors, including age, obesity, diabetes mellitus and metabolic syndrome. Atherosclerosis has the potential to promote the development of thrombotic disorders in the venous system. Another scenario assumes that the two clinical conditions are simultaneously triggered by biological stimuli responsible for activating coagulation and inflammatory pathways in both the arterial and the venous system. Several recent studies have consistently shown that patients with VTE of unknown origin are at a higher risk of cardiovascular diseases, including atherosclerotic complications, than patients with secondary VTE and matched control individuals. Future studies are needed to clarify the nature of this association, to assess its extent and to evaluate its implications for clinical practice.

  18. Clinical quality indicators of venous leg ulcers

    DEFF Research Database (Denmark)

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

    2005-01-01

    %) were assessed for venous surgery. Distal arterial pressure was measured following initial examination in 33 of the patients (34%). All patients (100%) were prescribed compression therapy. Of the 98 patients, 11 (11%) had ulcers recur in 3 months and 72 (73%) healed in 12 months, which is in line......In the clinical setting, diagnosis and treatment of venous leg ulcers can vary considerably from patient to patient. The first step to reducing this variation is to document venous leg ulcer care through use of quantitative scientific documentation principles. This requires the development of valid...... 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. [Emphysematous gastritis with concomitant portal venous air].

    Science.gov (United States)

    Jeong, Min Yeong; Kim, Jin Il; Kim, Jae Young; Kim, Hyun Ho; Jo, Ik Hyun; Seo, Jae Hyun; Kim, Il Kyu; Cheung, Dae Young

    2015-02-01

    Emphysematous gastritis is a rare form of gastritis caused by infection of the stomach wall by gas forming bacteria. It is a very rare condition that carries a high mortality rate. Portal venous gas shadow represents elevation of intestinal luminal pressure which manifests as emphysematous gastritis or gastric emphysema. Literature reviews show that the mortality rate is especially high when portal venous gas shadow is present on CT scan. Until recently, the treatment of emphysematous gastritis has been immediate surgical intervention. However, there is a recent trend of avoiding surgery because of the frequent occurrence of post-operative complications such as anastomosis leakage. In addition, aggressive surgical treatment has failed to show significant improvement in prognosis. Recently, the authors experienced a case of emphysematous gastritis accompanied by portal venous gas which was treated successfully by conservative treatment without immediate surgical intervention. Herein, we present a case of emphysematous gastritis with concomitant portal venous air along with literature review.

  20. A Rare Venous Port Complication: Supraventriculer Tachycardia

    Directory of Open Access Journals (Sweden)

    Tamer Yoldaş

    2016-04-01

    Full Text Available Implantable central venous port catheters are widely used in the management of children with cancer undergoing long term chemotherapy. These catheters can manifest a number of complications such as arrhythmia. Central venous port catheter was placed on a ten years old boy for chemotherapy. Before insertion of port catheter his physical examination, laboratory parameters, electrocardiography and echocardiography were normal. The patient felt palpitations shortly after the insertion of the port catheter. At that time the heart rate was 200 beats/minute but immediately normal sinus rhythm was restored. A chest roentgenogram revealed that the distal fragment of the port catheter was inside the right atrium. The port catheter was pulled back somewhat and then tachycardia attacks stopped. To our knowledge there are a few reports of supraventricular tachycardia (SVT in children associated with central venous port catheter. Here we aimed to present a pediatric case with SVT after placement of central venous port catheter and his management.

  1. Imaging of head and neck venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Flis, Christine M.; Connor, Stephen E. [King' s College Hospital, Neuroradiology Department, London (United Kingdom)

    2005-10-01

    Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team. (orig.)

  2. Prospects of Jugular Venous Pulse Assessment

    Directory of Open Access Journals (Sweden)

    M D Bhattarai

    2010-09-01

    Full Text Available There is no controversy regarding the current clinical method of examination of waveform of jugular vein pulse. However there are limitations of clinical assessment of central venous pressure by jugular vein pressure measurement from the level of sternal angle. There are variations in the reported distances from sternal angle to right atrium as well as to upper limit of JVP. In erect position, anterior end of fourth intercostal space is at about the level of mid-right atrium. In patients with visible JVP at neck in erect position, measurement of CVP can be done more accurately directly from the anterior end of fourth intercostal space. For others, the position of mid-right atrium can be marked in lateral chest wall first in erect position at the mid-point of an anteroposterior line from anterior end of fourth intercostal space to back. Subsequently in reclining position, the vertical height of venous pressure can be measured from the horizontal plane of the midpoint marked at lateral chest wall to visible upper limit of JVP. Such measurement can be done in a more reliable way with venous pressure (VP manometer with its indicator rod at the horizontal plane of mid-right atrium and with its horizontal surface at upper limit of JVP. The venous pressure manometer can also be used to measure relatively less reliable upper limb venous pressure (ULVP, as indicated by the vertical distance at which veins of upper limb collapse, especially when JVP is not visualized due to subnormal CVP as in hypovolemia. Keywords: CVP, JVP, right atrium, sternal angle, upper limp venous pressure, venous pressure, venous pressure manometer

  3. 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

  4. Multiple Extrasplanchnic Venous Thromboses: A Rare Complication of Pancreatitis. A Case Report

    Directory of Open Access Journals (Sweden)

    Hardik Parikh

    2012-05-01

    Full Text Available Context Venous thrombosis has been described in patients with acute and chronic pancreatitis. This is especially common in portal vein, splenic vein and superior mesenteric vein. To the best of our knowledge, involvement of superior vena cava and subclavian vessel due to pancreatitis has not been reported. Case report We present here a case of an adult male with alcoholic chronic pancreatitis who presented with multiple vessel thromboses involving superior vena cava, inferior vena cava, bilateral subclavian, internal jugular vein, axillary, iliac and renal vein without involvement of portal, splenic and superior mesenteric vein that was effectively treated with i.v. anticoagulation therapy. Conclusion Venous thromboses can occur outside the splanchnic circulation in pancreatitis.

  5. 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.

  6. Herb pair Danggui-Honghua: mechanisms underlying blood stasis syndrome by system pharmacology approach

    Science.gov (United States)

    Yue, Shi-Jun; Xin, Lan-Ting; Fan, Ya-Chu; Li, Shu-Jiao; Tang, Yu-Ping; Duan, Jin-Ao; Guan, Hua-Shi; Wang, Chang-Yun

    2017-01-01

    Herb pair Danggui-Honghua has been frequently used for treatment of blood stasis syndrome (BSS) in China, one of the most common clinical pathological syndromes in traditional Chinese medicine (TCM). However, its therapeutic mechanism has not been clearly elucidated. In the present study, a feasible system pharmacology model based on chemical, pharmacokinetic and pharmacological data was developed via network construction approach to clarify the mechanisms of this herb pair. Thirty-one active ingredients of Danggui-Honghua possessing favorable pharmacokinetic profiles and biological activities were selected, interacting with 42 BSS-related targets to provide potential synergistic therapeutic actions. Systematic analysis of the constructed networks revealed that these targets such as HMOX1, NOS2, NOS3, HIF1A and PTGS2 were mainly involved in TNF signaling pathway, HIF-1 signaling pathway, estrogen signaling pathway and neurotrophin signaling pathway. The contribution index of every active ingredient also indicated six compounds, including hydroxysafflor yellow A, safflor yellow A, safflor yellow B, Z-ligustilide, ferulic acid, and Z-butylidenephthalide, as the principal components of this herb pair. These results successfully explained the polypharmcological mechanisms underlying the efficiency of Danggui-Honghua for BSS treatment, and also probed into the potential novel therapeutic strategies for BSS in TCM.

  7. 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.

  8. 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.

  9. Anabolism-Associated Mitochondrial Stasis Driving Lymphocyte Differentiation over Self-Renewal

    Directory of Open Access Journals (Sweden)

    William C. Adams

    2016-12-01

    Full Text Available Regeneration requires related cells to diverge in fate. We show that activated lymphocytes yield sibling cells with unequal elimination of aged mitochondria. Disparate mitochondrial clearance impacts cell fate and reflects larger constellations of opposing metabolic states. Differentiation driven by an anabolic constellation of PI3K/mTOR activation, aerobic glycolysis, inhibited autophagy, mitochondrial stasis, and ROS production is balanced with self-renewal maintained by a catabolic constellation of AMPK activation, mitochondrial elimination, oxidative metabolism, and maintenance of FoxO1 activity. Perturbations up and down the metabolic pathways shift the balance of nutritive constellations and cell fate owing to self-reinforcement and reciprocal inhibition between anabolism and catabolism. Cell fate and metabolic state are linked by transcriptional regulators, such as IRF4 and FoxO1, with dual roles in lineage and metabolic choice. Instructing some cells to utilize nutrients for anabolism and differentiation while other cells catabolically self-digest and self-renew may enable growth and repair in metazoa.

  10. 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.

  11. 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.

  12. 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.

  13. What happens after venous thromboembolism?

    Science.gov (United States)

    Baglin, T

    2009-07-01

    Venous thromboembolism (VTE) comprises deep vein thrombosis (DVT) with or without symptomatic pulmonary embolus (PE). The incidence of a first episode of VTE is 1.5 per 1000 person-years [1] (J Thromb Haemost, 2007;5:692-9) with a per-person lifetime incidence of 5% [2] (Arch Intern Med 1998;158:585-93). The risk of recurrence after DVT and PE is similar but the pattern of recurrence tends to reflect the initial event, for example recurrence with PE is more common in patients with previous PE [3] (Circulation 2003;107:122-30). At least 50% of patients, who present with symptomatic DVT, have asymptomatic PE and conversely, a majority presenting with symptomatic PE have asymptomatic DVT [3] (Circulation 2003;107:122-30). This suggests that whilst DVT and PE are manifestations of the same pathology, the phenotypic expression of the disease is predetermined. This may be an important consideration for long-term anticoagulant therapy as the risk of fatal PE is the greatest in patients with previous PE [4] (Ann Intern Med 2007;147:766-74). At present, the only factor reported to be associated with the pattern of VTE is the factor V Leiden mutation [5] (Thromb Haemost 1999;81:345-8). This suggests that the kinetics of thrombin generation and the resulting fibrinolytic response may influence clot structure and likelihood of embolization.

  14. 脉络舒通颗粒和喜辽妥乳膏治疗下肢静脉功能不全皮肤色素沉着的随机对照临床研究%Efficacy of Chinese herbal medicine Mailuo Shutong Granule and Hirudoid cream for chronic venous disorder-induced pigmentation in lower extremities: a prospective, randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    魏小龙; 冯睿; 赵志青; 景在平

    2011-01-01

    背景:下肢静脉功能不全(chronic venous disorder,CVD)常导致色素沉着等皮肤营养改变,如不能获得有效治疗,可发展至皮肤溃疡坏死等严重并发症.目的:评估脉络舒通颗粒和喜辽妥乳膏治疗下肢CVD色素沉着的临床疗效.设计、场所、对象和干预措施:所有病例均为2010年8月至12月长海医院血管外科的门诊CVD患者.采用随机、对照的研究方法,将108例CVD色素沉着患者分为脉络舒通组(仅给予脉络舒通颗粒)、喜辽妥组(仅给予喜辽妥乳膏)和联合治疗组(同时给予脉络舒通颗粒和喜辽妥乳膏).疗程为28 d.主要结局指标:观察治疗前后CVD色素沉着区域的面积和平均灰度值的改变.结果:脉络舒通组33例,喜辽妥组34例,联合治疗组31例纳入统计分析.经治疗后3组患者皮肤色素沉着面积均减小,平均灰度值均降低(P<0.05).联合治疗组色素沉着面积减小和平均灰度值降低程度较脉络舒通组和喜辽妥组更为明显(P<0.05),而脉络舒通组和喜辽妥组组间比较差异无统计学意义(P>0.05).结论:脉络舒通颗粒和喜辽妥软膏对下肢CVD皮肤色素沉着均具有良好的疗效,二者合用则效果更佳.%Background: Chronic venous disorder (CVD) of the lower extremities generally induces dermatologic complicationsin lower extremity skin, such as hyperpigmentation. If not treated effectively, the lesions may develop intosevere outcomes, including dermal ulcer or necrosis.Objective; To evaluate the clinical efficacy of Mailuo Shutong Granule, a compound traditional Chinese herbalmedicine, and Hirudoid cream (heparinoid), in treatment of patients with dermal hyperpigmentation of skincaused by CVD.Design, setting, participants and interventions; A total of 108 CVD outpatients with pigmentation fromDepartment of Vascular Surgery, Shanghai Changhai Hospital were randomly divided into Mailuo Shutonggroup, Hirudoid group and combined therapy group

  15. Quality of life assessment of patients with and without venous ulcer

    Directory of Open Access Journals (Sweden)

    Thalyne Yurí Araújo Farias Dias

    2014-08-01

    Full Text Available OBJECTIVES: to compare the quality of life of patients with chronic venous disease with and without ulcer and to identify the most affected aspects.METHOD: cross-sectional study with a sample of 204 patients with chronic venous disease. The quality of life was assessed with the help of the SF-36 questionnaire. To compare the scores between the groups, the Mann-Whitney test was used, considering a statistically significant difference when p<0.05.RESULTS: the quality of life score of patients with ulcer was lower when compared to that of patients without ulcer, in all domains and dimensions of the SF-36, particularly in the domains physical aspect and functional capacity, with very low scores.CONCLUSION: all aspects of quality of life were more compromised in people with ulcers. These findings can contribute towards a better understanding of the effects of chronic venous disease on the quality of life and towards a better orientation of therapeutic interventions in this population.

  16. Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

    NARCIS (Netherlands)

    van Beest, Paul A.; van der Schors, Alice; Liefers, Henriette; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michael A.; Spronk, Peter E.

    2012-01-01

    Objective:  The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients. Design:  Prospective observational controlled study. Setting:  Nonacademic university-affiliated t

  17. Cortical blindness as a rare presentation of cerebral venous thrombosis.

    Science.gov (United States)

    Wang, Bonnie; Moon, Seong-Jin; Olivero, William C; Wang, Huan

    2013-05-09

    Cerebral venous thrombosis (CVT) remains a diagnostic and therapeutic challenge for clinicians. Manifesting in a remarkably wide spectrum of symptoms and signs, CVT often presents in a misleading fashion-if unrecognized or misdiagnosed, it carries potentially fatal consequences. Visual loss is quite rare as the initial presentation of CVT and is typically a finding more frequent in chronic cases with associated papilledema on funduscopy Ferro, Lopes, Rosas and Fontes (Delay in Hospital Admission of Patients with Cerebral Vein and Dural Sinus Thrombosis. Cerebrovasc Dis 2005;19: :152-6). We report a rare case of acute cortical blindness as the initial presentation of CVT in an 18-year-old female patient and review the current literature.

  18. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  19. Pharmacologic treatment of venous leg ulcers.

    Science.gov (United States)

    Dormandy, J A

    1995-01-01

    In terms of prevalence, total cost and morbidity, venous leg ulcers are probably by far the most important type of ulcerations in the leg. The macrocirculatory defect leading to a raised ambulatory venous pressure is now accepted as a common initial pathologic pathway. Most current treatment modalities, such as surgery or external compression, are designed to control the macrovascular defect. However, it is the microcirculatory consequences of the venous hypertension that give rise to the trophic skin changes and ultimately to ulceration. At this microcirculatory level, pharmacotherapy may be a useful adjunct in the treatment of venous leg ulcers. The microcirculatory pathophysiologic changes include decreased fibrinolytic activity, elevated plasma fibrinogen, microcirculatory thrombi, and inappropriate activation of the white blood cells. The oxidative burst from the activated white cells probably plays a key role by releasing locally leukocyte-derived free radicals, proteolytic enzymes, cytokines, platelet-activating factor, and a number of other noxious mediators. An important additional component in recalcitrant venous ulcers is co-existing arterial disease, which is probably present in 15-20% of cases. Decreased arterial perfusion pressure will further aggravate the ischemic changes caused by the venous hypertension. Pentoxifylline downregulates leukocyte activation, reduces leukocyte adhesion, and also has fibrinolytic effects. A number of clinical studies have therefore been carried out to examine the clinical efficacy of pentoxifylline in treatment of venous leg ulcers. Probably the largest published placebo-controlled, double-blind randomized study was reported in 1990. In this study, 80 patients received either pentoxifylline 400 mg three times a day orally or matching placebo for 6 months or until their reference ulcer healed if this occurred sooner. Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with pentoxifylline

  20. 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...... and 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...... with pulmonary embolism. Conclusion: Venous thromboembolism has a strong familial component....

  1. Evolutionary Stasis in Cycad Plastomes and the First Case of Plastome GC-Biased Gene Conversion.

    Science.gov (United States)

    Wu, Chung-Shien; Chaw, Shu-Miaw

    2015-06-27

    In angiosperms, gene conversion has been known to reduce the mutational load of plastid genomes (the plastomes). Particularly, more frequent gene conversions in inverted repeat (IR) than in single copy (SC) regions result in contrasting substitution rates between these two regions. However, little has been known about the effect of gene conversion in the evolution of gymnosperm plastomes. Cycads (Cycadophyta) are the second largest gymnosperm group. Evolutionary study of their plastomes is limited to the basal cycad genus, Cycas. In this study, we addressed three questions. 1) Do the plastomes of other cycad genera evolve slowly as previously observed in the plastome of Cycas taitungensis? 2) Do substitution rates differ between their SC and IR regions? And 3) Does gene conversion occur in the cycad plastomes? If yes, is it AT-biased or GC-biased? Plastomes of eight species from other eight genera of cycads were sequenced. These plastomes are highly conserved in genome organization. Excluding ginkgo, cycad plastomes have significantly lower synonymous and nonsynonymous substitution rates than other gymnosperms, reflecting their evolutionary stasis in nucleotide mutations. In the IRs of cycad plastomes, the reduced substitution rates and GC-biased mutations are associated with a GC-biased gene conversion (gBGC) mechanism. Further investigations suggest that in cycads, gBGC is able to rectify plastome-wide mutations. Therefore, this study is the first to uncover the plastomic gBGC in seed plants. We also propose a gBGC model to interpret the dissimilar evolutionary patterns as well as the compositionally biased mutations in the SC and IR regions of cycad plastomes.

  2. Intron distribution in Plantae: 500 million years of stasis during land plant evolution.

    Science.gov (United States)

    Teich, René; Grauvogel, Carina; Petersen, Jörn

    2007-06-01

    Little is known about the evolution of the intron-exon organization in the more primitive groups of land plants, and the intron distribution among Plantae (glauco-, rhodo-, chloro- and streptophytes) has not been investigated so far. The present study is focused on some key species such as the liverwort Marchantia polymorpha, representing the most ancient lineage of land plants, and the streptophycean green alga Mesostigma viride, branching prior to charophycean green algae and terrestrial plants. The intron distribution of six genes for sugar phosphate metabolism was analyzed including four different glyceraldehyde-3-phosphate dehydrogenases (GAPDH), the sedoheptulose-1,7-bisphosphatase (SBP) and the glucose-6-phosphate isomerase (GPI). We established 15 new sequences including three cDNA and twelve genomic clones with up to 24 introns per gene, which were identified in the GPI of Marchantia. The intron patterns of all six genes are completely conserved among seed plants, lycopods, mosses and even liverworts. This intron stasis without any gain of novel introns seem to last for nearly 500 million years and may be characteristic for land plants in general. Some unique intron positions in Mesostigma document that a uniform distribution is no common trait of all streptophytes, but it may correlate with the transition to terrestrial habitats. However, the respective genes of chlorophycean green algae display largely different patterns, thus indicating at least one phase of massive intron rearrangement in the green lineage. We moreover included rhodophyte and glaucophyte reference sequences in our analyses and, even if the well documented monophyly of Plantae is not reflected by a uniform intron distribution, at least one GPI intron is strictly conserved for 1.5 billion years.

  3. Granulomatosis de Wegener Semejando Cáncer Epidermoide de Nasofaringe y Metástasis Pulmonares.

    Directory of Open Access Journals (Sweden)

    Gustavo Adolfo Martín Small

    2011-01-01

    Full Text Available La granulomatosis de Wegener (GW es una enfermedad idiopática, con posible componente autoinmune, que aparece generalmente en la quinta década de vida, caracterizándose por lesiones granulomatosas necrotizantes y vasculitis en vías aéreas y riñón. Paciente femenino de 54 años, quien desde Noviembre del 2008, presenta rinorrea, prurito y eritema en borde nasal inferior izquierdo, recibe antibióticos sin mejoría de los síntomas. En las radiografías torácicas, se observan dos radiopacidades redondeadas, de 4 cm de diámetro, sugestivas de lesiones tumorales en ambos campos pulmonares. La biopsia reporta cáncer epidermoide de alto grado, sospechándose primario en nasofaringe. Es remitida, por deterioro de condiciones, al Servicio de Neumonología del Hospital Universitario de Caracas el 18/03/2009, presentando disnea, tos productiva, placas purpúricas dolorosas en manos y pies, hipoacusia, hiperpigmentación del paladar duro, leucoplaquias y lesiones costrosas en lengua, insuficiencia renal (creatinina en 6,11 mg/dL y trombocitopenia. En TAC de tórax, se evidencian tumores mayores de 5 cm de diámetro, algunos con bordes bien definidos y otros mal delimitados con broncograma aéreo. Diagnostico definitivo de GW por serología. La GW con su afectación sistémica puede simular otras entidades como neoplasias de cabeza y cuello con metástasis pulmonares. Cuando las manifestaciones sistémicas son floridas debe sospecharse GW como diagnóstico diferencial. Palabras claves: Wegener, Granulomatosis, Vasculitis, Cáncer epidermoide.

  4. Granulomatosis de Wegener Semejando Cáncer Epidermoide de Nasofaringe y Metástasis Pulmonares.

    Directory of Open Access Journals (Sweden)

    Gustavo Adolfo Martín Small

    2009-01-01

    Full Text Available La granulomatosis de Wegener (GW es una enfermedad idiopática, con posible componente autoinmune, que aparece generalmente en la quinta década de vida, caracterizándose por lesiones granulomatosas necrotizantes y vasculitis en vías aéreas y riñón. Paciente femenino de 54 años, quien desde Noviembre del 2008, presenta rinorrea, prurito y eritema en borde nasal inferior izquierdo, recibe antibióticos sin mejoría de los síntomas. En las radiografías torácicas, se observan dos radiopacidades redondeadas, de 4 cm de diámetro, sugestivas de lesiones tumorales en ambos campos pulmonares. La biopsia reporta cáncer epidermoide de alto grado, sospechándose primario en nasofaringe. Es remitida, por deterioro de condiciones, al Servicio de Neumonología del Hospital Universitario de Caracas el 18/03/2009, presentando disnea, tos productiva, placas purpúricas dolorosas en manos y pies, hipoacusia, hiperpigmentación del paladar duro, leucoplaquias y lesiones costrosas en lengua, insuficiencia renal (creatinina en 6,11 mg/dL y trombocitopenia. En TAC de tórax, se evidencian tumores mayores de 5 cm de diámetro, algunos con bordes bien definidos y otros mal delimitados con broncograma aéreo. Diagnostico definitivo de GW por serología. La GW con su afectación sistémica puede simular otras entidades como neoplasias de cabeza y cuello con metástasis pulmonares. Cuando las manifestaciones sistémicas son floridas debe sospecharse GW como diagnóstico diferencial.

  5. 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

  6. Radiologic placement of tunneled central venous catheter

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Seong Tae; Yang, Po Song; Yang, Dong Hunn; Kim, Ki Tae; Kim, Choon Yul; Shinn, Kyung Sub [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of); Yun, Eun Joo [Korea Veterans Hospital, Seoul (Korea, Republic of)

    1996-01-01

    To evaluate the efficacy and safety of fluoroscopy-guided, radiologic placement of a tunneled central venous catheter into the superior vena cava (SVC). Thirty five patients underwent tunneled central venous catheter placement to facilitate long-term chemotherapy. They included 33 leukemic patients, one colon cancer patient, and one multiple myeloma patient. After confirming central venous patency with a injection of contrast media via the peripheral cephalic or basilic vein in the wrist joint, the subclavian vein was punctured under fluoroscopic guidance. A 7F double lumen TPN catheter was placed into the SVC through a subcutaneous tunnel in the anterior chest wall. Catheter placements were successful in all patients. The mean procedure time was 17.2minutes, mean fluooscopy time was 1.3minutes, mean number of punctures was 1.4, and mean volume of injhected contrast media was 43.5cc. Only two of all leukemic patients developed mild hematomas at the puncture site, but these soon resolved themselves. None of the patients developed pneumothorax or hemothorax. But late complications included local infection in two patients (6%) and thrombotic occlusion of the catheter in one (3%). The occluded catheter was successfully recanalized with Urokinase infusion. Fluoroscopy-guided, radiologic placement of a tunneled central venous catheter is an easy and safe method, and useful for patients requiring long-term venous access.

  7. Treatment strategies for extensive chronic SFA occlusions: indications and results.

    NARCIS (Netherlands)

    Lensvelt, M.M.A.; Reijnen, M.M.P.J.; Wallis de Vries, B.M.; Zeebregts, C.J.A.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  8. Treatment strategies for extensive chronic SFA occlusions : indications and results

    NARCIS (Netherlands)

    Lensvelt, M. M. A.; Reijnen, M. M. P. J.; De Vries, B. M. Wallis; Zeebregts, C. J.

    2012-01-01

    Treatment modalities for extensive chronic occlusive disease of the superficial femoral artery (SFA) have changed during the last decades. In this chapter we provide an overview of current treatment modalities for extensive chronic occlusive disease of the SFA. Although the autologous venous conduit

  9. Prospective, Descriptive Study of Critically Colonized Venous Leg Ulcers Managed With Silver Containing Absorbent Dressings and Compression.

    Science.gov (United States)

    Moore, Michael F

    2013-08-01

    Chronic non-healing venous ulcers are by their very nature colonized with bacteria. The amount and make up will vary based on many variables. The transition from colonization to contamination, critical colonization, and infection complicates the treatment of these ulcers. Silver has been shown to be an effective antimicrobial agent with a diverse antimicrobial footprint, minimal allergic reactions, and has been employed for over twenty-five years with little resistance being encountered. Based on these factors, this study was initiated to evaluate the impact of silver containing absorbent dressings on critically colonized venous leg ulcers.

  10. We still go for the jugular: implications of the 3SITES central venous catheter study for nephrology.

    Science.gov (United States)

    Wyatt, Christina M; Vassalotti, Joseph A

    2016-03-01

    The 3SITES study randomly assigned a nontunneled central venous catheter site in over 3000 adults treated in intensive care units. The subclavian site was associated with a lower rate of short-term complications, including catheter-related bloodstream infection and deep venous thrombosis, compared to the femoral or internal jugular site. Nephrologists should be aware of this study and should continue to advocate for alternatives to subclavian vein catheter placement in patients with chronic kidney disease who are expected to require arteriovenous access for dialysis in the future.

  11. Prevalence of extracranial venous abnormalities: results from a sample of 586 multiple sclerosis patients.

    Science.gov (United States)

    Simka, M; Latacz, P; Ludyga, T; Kazibudzki, M; Swierad, M; Janas, P; Piegza, J

    2011-01-01

    The aim of this study was to assess the prevalence of chronic cerebrospinal venous insufficiency in an unselected cohort of multiple sclerosis (MS) patients. A total of 586 patients with clinically defined MS underwent catheter venography of the internal jugular veins, brachiocephalic veins and azygos vein. The following findings were regarded as pathologic: no outflow, slowed outflow, reversal of flow direction, prestenotic dilation accompanied by impaired outflow, outflow through collaterals, intraluminal structures obstructing the vein, hypoplasia, agenesia or significant narrowing of the vein. Venous abnormalities were found in 563 patients (96.1%). Lesions in one vein were found in 43.5%, in two veins in 49.5%, and in three veins in 3.1% of patients. Venous pathologies in the right internal jugular vein were found in 64.0% of patients, in the left internal jugular vein in 81.7%, in the left brachiocephalic vein in 1.0%, and in the azygos vein in 4.9%. Venous pathologies were found to be highly associated with MS, yet the clinical relevance of this phenomenon remains to be established.

  12. 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.

  13. Central Venous Catheter-Related Hydrothorax

    Directory of Open Access Journals (Sweden)

    Se Hun Kim

    2015-11-01

    Full Text Available This report describes a case of 88-year-old women who developed central venous catheter-related bilateral hydrothorax, in which left pleural effusion, while right pleural effusion was being drained. The drainage prevented accumulation of fluid in the right pleural space, indicating that there was neither extravasation of infusion fluid nor connection between the two pleural cavities. The only explanation for bilateral hydrothorax in this case is lymphatic connections. Although vascular injuries by central venous catheter can cause catheter-related hydrothorax, it is most likely that the positioning of the tip of central venous catheter within the lymphatic duct opening in the right sub-clavian-jugular confluence or superior vena cava causes the catheter-related hydrothorax. Pericardial effusion can also result from retrograde lymphatic flow through the pulmonary lymphatic chains.

  14. Infections associated with the central venous catheters.

    Science.gov (United States)

    Drasković, Biljana; Fabri, Izabella; Benka, Anna Uram; Rakić, Goran

    2014-01-01

    Central venous catheters are of an essential importance to critically ill patients who require long-term venous access for various purposes. Their use made the treatment much easier, but still they are not harmless and are prone to numerous complications. Catheter infections represent the most significant complication in their use. The frequency of infections varies in different patient care settings, but their appearance mostly depends on the patient's health condition, catheter insertion time, localization of the catheter and type of the used catheter. Since they are one of the leading causes of nosocomial infections and related to significant number of morbidity and mortality in intensive care units, it is very important that maximal aseptic precautions are taken during the insertion and the maintenance period. Prevention of infection of the central venous catheters demands several measures that should be applied routinely.

  15. Complement C3 and High Risk of Venous Thromboembolism

    DEFF Research Database (Denmark)

    Nørgaard, Ina; Nielsen, Sune Fallgaard; Nordestgaard, Børge Grønne

    2016-01-01

    BACKGROUND: Complement activation may contribute to venous thromboembolism, including deep venous thrombosis and pulmonary embolism. We tested the hypothesis that high complement C3 concentrations are associated with high risk of venous thromboembolism in the general population. METHODS: We...... similar for deep venous thrombosis and pulmonary embolism separately. The multivariable-adjusted hazard ratio for venous thromboembolism for a 1-g/L increase in complement C3 was 2.43 (1.74-3.40). CONCLUSIONS: High concentrations of complement C3 were associated with high risk of venous thromboembolism...... included 80 517 individuals without venous thromboembolism from the Copenhagen General Population Study recruited in 2003-2012. Plasma complement C3 concentrations were measured at baseline, and venous thromboembolism (n = 1176) was ascertained through April 2013 in nationwide registries. No individuals...

  16. 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.

  17. Imaging characteristics of two patients with isolated cortical venous thrombosis

    Institute of Scientific and Technical Information of China (English)

    Shunchang Han; Hui Zhang; Guoguang Fan; Baohai Sun

    2008-01-01

    BACKGROUND:Over the past twenty years, improvements in neuroimaging have greatly improved the ability to diagnose cerebral venous sinus thrombosis, as well as isolated cortical venous thrombosis. Neuroimaging allows for variations to be detected in the cortical vein and venous sinus. Diagnosis of thromboses in the venous system should not depend entirely on angiography of undeveloped veins or venous sinus. Currently, the combination of magnetic resonance imaging and magnetic resonance venography is the gold standard for diagnosing cerebral venous sinus thrombosis, rather than digital subtraction angiography. This article summarizes clinical manifestations, results from computed tomography and magnetic resonance imaging in two cases of isolated cortical venous thrombosis, analyzed relevant literature, and discussed the clinical and imaging characteristics of isolated cortical venous thromboses.

  18. The Relationship between Stasis-Stagnation Constitution and Peripheral Arterial Disease in Patients with Type 2 Diabetes

    OpenAIRE

    Kuo-Chin Huang; Ching-Chu Chen; Yi-Chang Su; Jui-Shan Lin; Chwen-Tzuei Chang; Tzu-Yuan Wang; Rong-Hsing Chen; Fuu-Jen Tsai

    2014-01-01

    Objectives. In traditional Chinese medicine, Yu-Zhi (YZ, indicating stasis and stagnation) constitution describes a body that tends to express abnormal circulatory conditions. This study identified the linkage between YZ constitution and peripheral arterial disease (PAD) in patients with type 2 diabetes. Methods. Patients over 20 years of age who had had type 2 diabetes for 5 years or longer were recruited. PAD was diagnosed if the ankle-brachial index score was ≤0.9 in either leg. Level of Y...

  19. Osteopatía hipertrófica secundaria a metástasis pulmonar de carcinoma mamario

    OpenAIRE

    2015-01-01

    Propósitos: este artículo pretende reportar los hallazgos de un caso clínico de osteopatía hipertrófica. Tema: la osteopatía hipertrófica es un raro desorden paraneoplásico, asociado con el sobrecrecimiento doloroso del periostio de los huesos largos, normalmente desencadenado por neoplasias primarias o metastásicas de pulmón. Desarrollo: se presenta el caso de un rottweiler, de 12 años, con osteopatía hipertrófica asociada con metástasis pulmonar de un carcinoma mamario. Conclusiones: se com...

  20. Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

    Institute of Scientific and Technical Information of China (English)

    刘巧平; 刘建华; 刘大新

    2003-01-01

    @@ Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.

  1. Lay Stress on Study of Venous Thromboembolism

    Institute of Scientific and Technical Information of China (English)

    刘泽霖

    2002-01-01

    @@ Venous thromboembolism (VTE) including deep vein thrombosis(DVT) and pulmonary embolism(PE).Its occurs in about 1 per 1 000 individuals per years.Thrombosis is a serious disorder. It may be fatal by PE (case fatality rate of venous thrombosis is estimated at 1% to 2%)(Figure 1 ). A substantial proportion of these deaths occur in the postoperative period, and many events are fatal before diagnosis can be made and therapy initiated. Just as well, the prophylactic treatment of thrombosis is focused on preventing first events and recurrences through adequate knowledge about risks and risk factors.

  2. Assessment of Venous Thrombosis in Animal Models.

    Science.gov (United States)

    Grover, Steven P; Evans, Colin E; Patel, Ashish S; Modarai, Bijan; Saha, Prakash; Smith, Alberto

    2016-02-01

    Deep vein thrombosis and common complications, including pulmonary embolism and post-thrombotic syndrome, represent a major source of morbidity and mortality worldwide. Experimental models of venous thrombosis have provided considerable insight into the cellular and molecular mechanisms that regulate thrombus formation and subsequent resolution. Here, we critically appraise the ex vivo and in vivo techniques used to assess venous thrombosis in these models. Particular attention is paid to imaging modalities, including magnetic resonance imaging, micro-computed tomography, and high-frequency ultrasound that facilitate longitudinal assessment of thrombus size and composition.

  3. 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...

  4. Comparison of skin and muscle biopsies before and after pentoxifylline treatment in patients with leg ulcers due to deep venous incompetence.

    Science.gov (United States)

    Angelides, N S; von der Ahe, C W; Themistocleus, P

    1991-01-01

    The aim of this study was to understand the possible mechanisms by which deep venous insufficiency and venous hypertension are associated with trophic skin changes and ulceration and to explain the therapeutic effect of Pentoxifylline in patients with leg ulcers due to deep venous incompetence. Twenty patients were included in this pilot study. They were graded into two groups: group 1, included 10 patients (5 F and 5 M) with deep venous incompetence and normal arteries; group 2, included 10 patients (1 F and 9 M) with deep venous incompetence and moderate arterial disease. Skin and muscle biopsies were carried out before and after the oral administration of 1,200 mg of Pentoxifylline daily (400 mg t.d.s). The following parameters were investigated by means of light microscopy and immunofluorescence tests: engorgement of venous stroma; decrease of intimal elastica; hyaline degeneration; floccular degeneration; pericapillary fibrin deposits and fibrin degradation products; inflammation and fat necrosis; myofibril degeneration; fibrous scar; regeneration and reconstitution of muscle fibres. The results indicated that local inflammation at the ulcer's area cause accumulation of white blood cells in the capillaries and the interstitial fluid, where there is also accumulation of fibrinogen. These changes may lead to chronic tissue ischaemia and ulceration. The known favourable effect of Pentoxifylline on red cells and leucocyte function as well as its lowering effect on plasma fibrinogen level, may be responsible for the observed therapeutic effect of Pentoxifylline on venous leg ulcers.

  5. Samario-153-Lexidronam (EDTMP) en el tratamiento de las metástasis óseas Samarium-153-Lexidronam (EDTMP) for the management of bone metastases

    OpenAIRE

    2004-01-01

    Las metástasis óseas son una complicación frecuente en pacientes neoplásicos, en este sentido, el tejido óseo ocupa el tercer lugar de todos los órganos y sistemas con metástasis después del pulmón e hígado. Aproximadamente un 75% de los enfermos con metástasis óseas sufrirán dolor, siendo estas la causa más frecuente de dolor en pacientes con cáncer. El dolor óseo aumenta con los movimientos y a la presión, limitando la autonomía del enfermo y su calidad de vida. El tratamiento incluye vario...

  6. Physical activity, immobilization and the risk of venous thrombosis

    NARCIS (Netherlands)

    Stralen, Karlijn Janneke van

    2008-01-01

    Deep venous thrombosis is a common disease. Already in 1856 it was suggested that immobilization could cause venous thrombosis. However, so far little research has shown whether exercise or ambulation could decrease the risk of venous thrombosis. We performed a historical review regarding the role o

  7. Lymphatic and venous function in lipoedema.

    Science.gov (United States)

    Harwood, C A; Bull, R H; Evans, J; Mortimer, P S

    1996-01-01

    Lipoedema is a common but infrequently recognized condition causing bilateral enlargement of the legs in women. Although generally considered to be the result of an abnormal deposition of subcutaneous fat with associated oedema, the precise mechanisms responsible for oedema formation have yet to be fully established. In order to evaluate the possible role of lymphatic or venous dysfunction in the pathogenesis of lipoedema, 10 patients were investigated by photoplethysmography (venous function) and quantitative lymphoscintigraphy (lymphatic function). The results were compared with those from patients with primary lymphoedema and those from healthy volunteers. The results demonstrated minor abnormalities of venous function in only two patients. One patient had moderately impaired lymphatic function in both legs and seven patients had a marginal degree of impairment in one or both legs. However, in none of these cases did the impairment attain the low levels seen in true lymphoedema. Lipoedema appears to be a distinct clinical entity best classified as a lipodystrophy rather than a direct consequence of any primary venous or lymphatic insufficiency.

  8. 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.

  9. [Femoral venous catheter: an unusual complication].

    Science.gov (United States)

    Garcia, P; Mora, A; Trambert, P; Maler, E; Courant, P

    2000-08-01

    We report an erratic course of a venous femoral catheter which was in the abdominal cavity in a patient with an haemoperitoneum and an hepatic injury. This complication led to an inefficiency of the transfusion and a worsening of the haemoperitoneum.

  10. Diagnosing deep venous thrombosis in primary care

    NARCIS (Netherlands)

    Oudega, Rudolphus

    2005-01-01

    In patients suspected of deep venous thrombosis (DVT) in primary care, it is a challenge to discriminate the patients with DVT from those without DVT. The risk of missing the diagnosis and the risk of unnecessary referral and treatment with a potential harmful therapy has to be balanced by the prima

  11. Microalbuminuria and Risk of Venous Thromboembolism

    NARCIS (Netherlands)

    Mahmoodi, Bakhtawar K.; Gansevoort, Ron T.; Veeger, Nic J. G. M.; Matthews, Abigail G.; Navis, Gerjan; Hillege, Hans L.; van der Meer, Jan

    2009-01-01

    Context Microalbuminuria (albuminuria 30-300 mg per 24-hour urine collection) is a well-known risk marker for arterial thromboembolism. It is assumed that microalbuminuria reflects generalized endothelial dysfunction. Hence, microalbuminuria may also predispose for venous thromboembolism (VTE). Obje

  12. 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.

  13. Treatment of Cancer-Associated Venous Thrombosis

    NARCIS (Netherlands)

    G.L. van Sluis; H.R. Buller

    2009-01-01

    Venous thromboembolism (VTE) is an important complication in cancer patients, which is associated with bad outcome. Increased recurrence rates and bleeding complications as compared to non-cancer patients during the treatment of VTE, require special attention. This review aims to summarize the avail

  14. 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.

  15. 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.

  16. Cerebral venous thrombosis presenting with cerebellar ataxia and cortical blindness.

    Science.gov (United States)

    Ben Sassi, Samia; Mizouni, Habiba; Nabli, Fatma; Kallel, Lamia; Kefi, Mounir; Hentati, Fayçal

    2010-01-01

    Venous infarction in the cerebellum has been reported only rarely, probably because of the abundant venous collateral drainage in this region. Bilateral occipital infarction is a rare cause of visual loss in cerebral venous thrombosis. We describe a 50-year-old woman with a history of ulcerative colitis who developed acute cerebellar ataxia and cortical blindness. She had bilateral cerebellar and occipital lesions related to sigmoid venous thrombosis and achieved complete recovery with anticoagulation therapy. Cerebral venous thrombosis should be considered in cases of simultaneous cerebellar and occipital vascular lesions.

  17. Association between thrombophilia and seated immobility venous thromboembolism.

    Science.gov (United States)

    Siniarski, Aleksander; Wypasek, Ewa; Fijorek, Kamil; Gajos, Grzegorz; Undas, Anetta

    2014-03-01

    Prolonged work and recreation-related seated immobility increases the risk of venous thromboembolism (VTE). Little is known about links of thrombophilia and prolonged immobility. We sought to determine factors associated with the occurrence of seated immobility venous thromboembolism (SIT). Four hundred and ninety-three consecutive outpatients with a history of first-ever VTE, aged up to 65 years were referred for evaluation of suspected thrombophilia. Exclusion criteria were provoked VTE unless family history of VTE was positive, arterial thrombosis, cancer, infection and chronic inflammatory diseases. The prolonged immobility group was defined as being seated at least 8 h daily and at least 3 h daily without getting up, or 10 h daily and 2 h daily without getting up, or 12 h daily and 1 h daily without getting up during 12 weeks prior to VTE onset. SIT was observed in 115 patients (24.5%). Inherited thrombophilia was more common among SIT patients than in the remainder [Odds ratio (OR) 3.98, 95% confidence interval (CI) 2.55-6.25], with a major impact of factor V Leiden mutation (FVL) (OR 4.86, 95% CI 2.95-8.05). In multivariate analysis, FVL (OR 5.43, 95% CI 3.23-9.15), trauma (OR 2.55, 95% CI 1.30-4.99), current smoking (OR 1.68, 95% CI 1.06-2.67) and varices (OR 2.08, 95% CI 1.27-3.40) were independent predictors of SIT. Moreover, FVL (OR 4.05, 95% CI 2.12-7.76), prothrombin G20210A variant (OR 3.84, 95% CI 1.47-10.05) and computer use (OR 2.84, 95% CI 1.43-5.63) were independent predictors of unprovoked VTE in the SIT group. Inherited thrombophilia, current smoking and varices characterize patients with SIT.

  18. Advances in diagnosis and treatment of cerebral venous system diseases

    Directory of Open Access Journals (Sweden)

    Xiao-yun LIU

    2016-11-01

    Full Text Available Cerebral venous system diseases include cerebral venous thrombosis (CVT, venous sinus stenosis, carotid cavernous fistula (CCF, intracranial arteriovenous malformation (AVM and so on. In recent years, due to the rapid development of neuroimaging and interventional technology, more and more cerebral venous system diseases have been timely diagnosed and treated, such as magnetic resonance black-blood thrombus imaging (MRBTI in the diagnosis of CVT, stenting in the treatment of venous sinus stenosis, micro coil plus Onyx glue or covered stents in the treatment of CCF, which allow us to make a deeper recognition of cerebral venous system diseases. Therefore, this paper will introduce the latest diagnosis and treatment of cerebral venous system diseases. DOI: 10.3969/j.issn.1672-6731.2016.11.006

  19. [Medial venous catheter or midline (MVC)].

    Science.gov (United States)

    Carrero Caballero, Ma Carmen; Montealegre Sanz, María; Cubero Pérez, Ma Antonia

    2014-01-01

    Current clinical practice is characterised for importance of the patient's quality of life and the need to reduce the costs of their treatment. We search intravenous therapy alternatives that meet the needs of the patient, reducing the complications associated with the use of venous catheters. Scientific evidence shows that there are midline venous catheters that offer patients and professionals the possibility of extending the duration of infusion therapy, using more venous compatibility materials, and with less risk of infection. The Midlines are becoming in a safe an efficient device for intravenous therapy, continuous and intermittent infusion, provided the necessary care by expert nurses. Midline catheters are peripheral venous access devices between 3 to 10 inches in length (8 to 25 cm). Midlines are usually placed in an upper arm vein, such as the brachial or cephalic, and the distal extreme ends below the level of the axillary line. Midlines catheters implanted in the cephalic or deep basilica veins get more blood flow. This large blood volume justifies the lower risk of mechanical or chemical phlebitis. Midlines are routinely used for two to six weeks. Due that the extrem of these catheters does not extend beyond the axillary line, there are limitations for its use: type of infused drugs, velocity of infusion, etc. In general, solutions that have pH 5 to 9, or an osmolarity less than 500 mOsm are appropriate for infusion through a Midline. Its use is recommended in case of treatments over 7 days with low irritant capacity fluids. According to the Infusion Nurses Society's standards of practice, Midline catheters are appropriate for all intravenous fluids that would normally be administered through a short peripheral IV Importantly, due that the catheter does not pass through the central veins, Midlines can be placed without a chest X-ray to confirm placement. For certain situations, Midlines are suitable for acute units and even for care home settings

  20. Risk factors for venous thrombosis associated with peripherally inserted central venous catheters.

    Science.gov (United States)

    Pan, Longfang; Zhao, Qianru; Yang, Xiangmei

    2014-01-01

    To evaluate the risk factors associated with an increased risk of symptomatic peripherally inserted central venous catheter (PICC)-related venous thrombosis. Retrospective analyses identified 2313 patients who received PICCs from 1 January 2012 to 31 December 2013. All 11 patients with symptomatic PICC-related venous thrombosis (thrombosis group) and 148 who did not have thromboses (non-thrombosis group) were selected randomly. The medical information of 159 patients (age, body mass index (BMI), diagnosis, smoking history, nutritional risk score, platelet count, leucocyte count as well as levels of D-dimer, fibrinogen, and degradation products of fibrin) were collected. Logistic regression analysis was undertaken to determine the risk factors for thrombosis. Of 2313 patients, 11 (0.47%) were found to have symptomatic PICC-related venous thrombosis by color Doppler ultrasound. Being bedridden for a long time (odds ratio [(OR]), 17.774; P=0.0017), D-dimer >5 mg/L (36.651; 0.0025) and suffering from one comorbidity (8.39; 0.0265) or more comorbidities (13.705; 0.0083) were the major risk factors for PICC-catheter related venous thrombosis by stepwise logistic regression analysis. Among 159 patients, the prevalence of PICC-associated venous thrombosis in those with ≥1 risk factor was 10.34% (12/116), in those with ≥2 risk factors was 20.41% (10/49), and in those with >3 risk factors was 26.67% (4/15). Being bedridden >72 h, having increased levels of D-dimer (>5 mg/L) and suffering from comorbidities were independent risk factors of PICC-related venous thrombosis.

  1. 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.

  2. Discussion on Theory of Phlegm and Blood Stasis Accumulation for Hypertension%高血压病痰瘀互结证理论探析

    Institute of Scientific and Technical Information of China (English)

    焦晓民; 阮琳

    2012-01-01

    原发性高血压病证属中医“眩晕”、“头痛”等范畴,痰瘀互结证为其常见证型.为能充分了解痰瘀互结型高血压病形成的病理基础,以期更好地指导高血压病的临床治疗,就痰瘀的形成及痰瘀互结与高血压的相关性做一论述.%Essential hypertension is attributable to vertigo, headache syndrome of traditional Chinese medicine. Syndrome of phlegm and blood stasis accumulation is the common syndrome. In order to fully understand the pathological basis of phlegm and blood stasis type of hypertension, and guide the clinical treatment of hypertension, this paper makes a discussion of the formation of phlegm and blood stasis and the relevance of phlegm and blood stasis syndrome and hypertension.

  3. Venous Thromboembolism in Patients With Thrombocytopenia

    DEFF Research Database (Denmark)

    Baelum, Jens Kristian; Moe, Espen Ellingsen; Nybo, Mads

    2017-01-01

    . OBJECTIVES: To identify VTE risk factors and describe treatment and outcome (bleeding episodes and mortality) in patients with thrombocytopenia. PATIENTS/METHODS: Patients with thrombocytopenia (platelet count ... with anticoagulants. There was no difference in bleeding incidence between cases and controls. CONCLUSIONS: Several known VTE risk factors also seems to apply in patients with thrombocytopenia. Also, patients with thrombocytopenia may be VTE risk stratified based on platelet count and comorbidities. Finally, patients......BACKGROUND: Venous thromboembolism (VTE) is a frequent and potentially lethal condition. Venous thrombi are mainly constituted of fibrin and red blood cells, but platelets also play an important role in VTE formation. Information about VTE in patients with thrombocytopenia is, however, missing...

  4. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the 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......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 focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  5. External jugular venous aneurysm: A clinical curiosity

    Science.gov (United States)

    Mohanty, Debajyoti; Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Tandon, Anupama

    2013-01-01

    Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity. PMID:23633867

  6. [Venous thromboembolism in patients with cancer].

    Science.gov (United States)

    Lecumberri, Ramón; Feliu, Jesús; Rocha, Eduardo

    2006-06-03

    The association between neoplastic diseases and venous thromboembolism (VTE) is known since long time ago. The nature of this association is bidirectional. On one hand, cancer increases the incidence of venous thrombosis and, on the other hand, the hemostatic system does play a key role in the tumorigenesis process. However, despite recent advances in the field, prophylaxis and treatment of VTE in cancer patients is still a challenge, due to the complexity of this type of patients. This review is focused on some important points regarding management of VTE in cancer patients such as physiopathology, epidemiology, search for hidden malignancy, prognostic impact, prophylaxis in the medical and surgical setting, or initial and long-term treatment.

  7. [Prevention of venous thromboembolism in musculoskeletal surgery].

    Science.gov (United States)

    Pabinger-Fasching, Ingrid; Eichinger-Hasenauer, Sabine; Grohs, Josef; Hochreiter, Josef; Kastner, Norbert; Korninger, Hans Christian; Kozek-Langenecker, Sibylle; Marlovits, Stefan; Niessner, Herwig; Rachbauer, Franz; Ritschl, Peter; Wurnig, Christian; Windhager, Reinhard

    2014-05-01

    Musculoskeletal surgery is associated with a high risk of venous thrombosis and pulmonary embolism. The introduction of direct oral anticoagulants (DOAK) has broadened the possibilities for prevention of venous thromboembolism in the course of orthopedic and trauma surgery. Addressing this recent development, the Austrian Societies of Orthopedics and Orthopedic Surgery (ÖGO), Trauma Surgery (ÖGU), Hematology and Oncology (OeGHO) and of Anaesthesiology, Reanimation und Intensive Care Medicine (ÖGARI) have taken the initiative to create Austrian guidelines for the prevention of thromboembolism after total hip and knee replacement, hip fracture surgery, interventions at the spine and cases of minor orthopedic and traumatic surgery. Furthermore, the pharmacology of the DOAK and the pivotal trial data for each of the three currently available substances - apixaban, dabigatran, and rivaroxaban - are briefly presented. Separate chapters are dedicated to "anticoagulation and neuroaxial anesthesia" and "bridging".

  8. Multiple venous thrombosis complicating central venous cannulation in a non cancer patient - a case report.

    Science.gov (United States)

    Peters, Ce; Menkiti, Id; Desalu, I; Thomas, Mo

    2013-01-01

    Central venous catheterization is a common procedure for critically ill patients. Like all procedures, it has its complications, one of which is thrombosis. Reports of thrombosis are commoner among cancer patients. We present a 37 year old non cancer patient who developed thrombi in both right and left internal jugular veins, 10 and 13 days respectively after insertion of central venous catheter. This was detected by ultrasound scans of the neck while attempting re-cannulation for parenteral feeding. She also had left lower limb deep venous thrombosis, confirmed by doppler scan, which was managed with low molecular weight heparin and warfarin. The patient was subsequently treated with streptokinase. A repeat scan of the internal jugular veins 4 days after thrombolysis revealed a reduction in size of the thrombi. Symptoms of deep venous thrombosis improved and she was transferred to the wards where she made remarkable improvement. This case illustrates the potential usefulness of ultrasound guided-central line insertion in patients who have had central venous lines inserted previously in order to detect thrombi.

  9. What's new: Management of venous leg ulcers: Approach to 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

    Leg ulcerations are a common problem, with an estimated prevalence of 1% to 2% in the adult population. Venous leg ulcers are primarily treated in outpatient settings and often are managed by dermatologists. Recent advances in the diagnosis and treatment of leg ulcers combined with available evidence-based data will provide an update on this topic. A systematized approach and the judicious use of expensive advanced therapeutics are critical. Specialized arterial and venous studies are most commonly noninvasive. The ankle brachial pressure index can be performed with a handheld Doppler unit at the bedside by most clinicians. The vascular laboratory results and duplex Doppler findings are used to identify segmental defects and potential operative candidates. Studies of the venous system can also predict a subset of patients who may benefit from surgery. Successful leg ulcer management requires an interdisciplinary team to make the correct diagnosis, assess the vascular supply, and identify other modifiable factors to optimize healing. The aim of this continuing medical education article is to provide an update on the management of venous leg ulcers. Part I is focused on the approach to venous ulcer diagnostic testing.

  10. Epidemiology and Risk Factors for Venous Thrombosis

    OpenAIRE

    Cushman, Mary

    2007-01-01

    Venous thrombosis, including deep vein thrombosis and pulmonary embolism, occurs at an annual incidence of about 1 per 1000 adults. Rates increase sharply after around age 45 years, and are slightly higher in men than women in older age. Major risk factors for thrombosis, other than age, include exogenous factors such as surgery, hospitalization, immobility, trauma, pregnancy and the puerperium and hormone use, and endogenous factors such as cancer, obesity, and inherited and acquired disorde...

  11. Cerebral venous sinus thrombosis with autoimmune thyroiditis

    Directory of Open Access Journals (Sweden)

    Sameer Aggarwal

    2013-01-01

    Full Text Available Cerebral Venous Thrombosis ( CVT is a multifactorial condition which is described as idiopathic in 12.5% of patients. Hyperthyroidism has been associated with CVT in many case reports, and increased levels of factor VIII and von Willebrand factor (vWF have been proposed as the possible link in this association, but only few rare case reports have described an association of hypothyroidism with CVT. We report here a case of autoimmune thyroiditis presenting with CVT.

  12. Aneurysmal portosystemic venous shunt: a case report.

    Science.gov (United States)

    Bodner, G; Glück, A; Springer, P; König, P; Perkmann, R

    1999-10-01

    A case of an aneurysmal portosystemic venous shunt detected by colour Doppler ultrasound (CDUS) is presented. A young female patient complained of postprandial fatigue and had paroxysmal tachycardia. A direct vascular communication between right portal vein and right hepatic vein was found at CDUS and confirmed by direct portal angiogram. Using detachable coils a complete occlusion of the intrahepatic shunt was obtained. Reports from the literature regarding portovenous aneurysms are reviewed.

  13. Congenital pseudoarthrosis associated with venous malformation

    Energy Technology Data Exchange (ETDEWEB)

    Al-Hadidy, A.; Haroun, A.; Al-Ryalat, N. [Jordan University Hospital, Radiology Department, P.O. Box 340621, Amman (Jordan); Hamamy, H. [Endocrinology and Genetics, National Center for Diabetes, Amman (Jordan); Al-Hadidi, S. [Jordan University Hospital, Departments of Orthopedics, Amman (Jordan)

    2007-06-15

    Congenital pseudoarthrosis is a pathologic entity that may be isolated, or may be associated with neurofibromatosis. We report the case of a 3-year-old female with congenital pseudoarthrosis involving the right tibia and fibula. Magnetic resonance imaging (MRI) and complementary magnetic resonance angiogram (MRA) revealed a lobulated mass with vivid enhancement, which led to the diagnosis of venous malformation. This is the first report of congenital pseudoarthrosis caused by the presence of a vascular malformation. (orig.)

  14. 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.

  15. Venous access: options, approaches and issues

    Energy Technology Data Exchange (ETDEWEB)

    Asch, M.R. [Univ. of Toronto, Mount Sinai Hospital, Dept. of Medical Imaging, Toronto, Ontario (Canada)

    2001-06-01

    Venous access is an essential part of medical practice. It is needed to obtain blood samples to make the diagnosis and to administer fluids or medicines as part of treatment. Although relatively new in the history of medicine, the placement and maintenance of the various venous access devices now occupies a significant portion of many vascular and interventional radiology practices. Thus, it is important to have a thorough understanding of these devices and their uses. The first long-term venous access devices were used in 1973. These were placed via a surgical cut-down on the subclavian vein. In 1982, the first subcutaneous implantable ports were described. These procedures were initially performed by surgeons, but over the last 5-10 years, both the insertion and management of these devices has shifted to interventional radiologists. Peripherally inserted central catheter (PICC) lines have almost completely supplanted the use of standard central lines (Fig. 1). A number of factors have facilitated this - namely, ready and less expensive room access, outpatient procedure and radiologists' accessibility and familiarity with image-guidance procedures and catheters and guide wires. (author)

  16. 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.)

  17. Transpulmonary passage of venous air emboli

    Science.gov (United States)

    Butler, B. D.; Hills, B. A.

    1985-01-01

    Twenty-seven paralyzed anesthetized dogs were embolized with venous air to determine the effectiveness of the pulmonary vasculature for bubble filtration or trapping. Air doses ranged from 0.05 to 0.40 ml/kg min in 0.05-ml increments with ultrasonic Doppler monitors placed over arterial vessels to detect any microbubbles that crossed the lungs. Pulmonary vascular filtration of the venous air infusions was complete for the lower air doses ranging from 0.05 to 0.30 ml/kg min. When the air doses were increased to 0.35 ml/kg min, the filtration threshold was exceeded with arterial spillover of bubbles occurring in 50 percent of the animals and reaching 71 percent for 0.40 ml/kg min. Significant elevations were observed in pulmonary arterial pressure and pulmonary vascular resistance. Systemic blood pressure and cardiac output decreased, whereas left ventricular end-diastolic pressure remained unchanged. The results indicate that the filtration of venous bubbles by the pulmonary vasculature was complete when the air infusion rates were kept below a threshold value of 0.30 ml/kg min.

  18. Weapons of Maths Instruction: A Thousand Years of Technological Stasis in Arrowheads from the South Scandinavian Middle Mesolithic

    Directory of Open Access Journals (Sweden)

    Kevan Edinborough

    2005-11-01

    Full Text Available This paper presents some results from my doctoral research into the evolution of bow-arrow technology using archaeological data from the south Scandinavian Mesolithic (Edinborough 2004. A quantitative approach is used to describe the morphological variation found in samples taken from over 3600 armatures from nine Danish and Swedish lithic assemblages. A linked series of statistical techniques determines the two most significant metric variables across the nine arrowhead assemblages in terms of the cultural transmission of arrowhead technology. The resultant scatterplot uses confidence ellipses to reveal highly distinctive patterns of morphological variation that are related to population-specific technological traditions. A population-level hypothesis of a socially constrained transmission mechanism is presented that may explain the unusually long period of technological stasis demonstrated by six of the nine arrowhead phase-assemblages.

  19. Sobrevida de pacientes con cáncer de mama y metástasis ósea

    OpenAIRE

    LOBOS M,ADRIANA; OLMEDO P,VALENTINA; ORTIZ B,EVELYN; OPAZO R,CLAUDIO

    2013-01-01

    Introducción: El cáncer de mama es una importante causa de muerte por cáncer en las mujeres chilenas. Metastatiza a cualquier parte del cuerpo, siendo hueso la primera zona de diseminación en 26-50% de los casos, encontrándose un 75% de los pacientes que fallecen por esta causa. Se reporta una sobrevida de 18-24 meses, y una supervivencia a los 5 años del 20%. El objetivo del siguiente trabajo es determinar la sobrevida ante presencia de metástasis óseas. Pacientes y Método: Se realizó un est...

  20. Breast metastasis of primary colon cancer Metástasis en mama de carcinoma primario de colon

    Directory of Open Access Journals (Sweden)

    L. Fernández de Bobadilla

    2004-06-01

    Full Text Available Metastatic tumors to the breast from colon adenocarcinoma are very rare. They are usually indicative of disseminated disease, and the prognosis is poor. Generally, radical operation should be avoided unless needed for palliation. This case report described a patient with breast metastasis from colon adenocarcinoma treated by simple mastectomy.La metástasis en la mama de tumores de colon es una entidad muy poco frecuente. El pronóstico a largo plazo es infausto, pues esta lesión es expresión de enfermedad sistémica. El tratamiento quirúrgico debe ser lo más conservador posible, ya que es un tratamiento paliativo. Presentamos un caso de esta rara entidad, tratada mediante mastectomía.

  1. Evaluation of electromechanical coupling parameters of piezoelectric materials by using piezoelectric cantilever with coplanar electrode structure in quasi-stasis.

    Science.gov (United States)

    Zheng, Xuejun; Zhu, Yuankun; Liu, Xun; Liu, Jing; Zhang, Yong; Chen, Jianguo

    2014-02-01

    Based on Timoshenko beam theory, a principle model is proposed to establish the relationship between electric charge and excitation acceleration, and in quasi-stasis we apply the direct piezoelectric effect of multilayer cantilever with coplanar electrode structure to evaluate the piezoelectric strain coefficient d15 and electromechanical coupling coefficient k15. They are measured as 678 pC/N and 0.74 for the commercial piezoelectric ceramic lead zirconate titanate (PZT-51) bulk specimen and 656 pC/N and 0.63 for the lead magnesium niobate (PMN) bulk specimen, and they are in agreement with the calibration and simulation values. The maximum of relative errors is less than 4.2%, so the proposed method is reliable and convenient.

  2. Effect of wine processing and acute blood stasis on the serum pharmacochemistry of rhubarb: a possible explanation for processing mechanism.

    Science.gov (United States)

    Wang, Min; Fu, Jinfeng; Lv, Mengying; Tian, Yuan; Xu, Fengguo; Song, Rui; Zhang, Zunjian

    2014-09-01

    As a specific item mentioned in traditional Chinese medicine theory, processing can fulfill different requirements of therapies. Crude and wine-processed rhubarbs are used as drastic and mild laxatives, respectively. In this study, a practical method based on ultra-fast liquid chromatography coupled with diode-array detection and ion trap time-of-flight mass spectrometry was developed to screen and analyze multiple absorbed bioactive components and metabolites in the serum of both normal and acute blood stasis rats after oral administration of crude or wine-processed rhubarbs. A total of 16 compounds, mainly including phase II metabolites, were tentatively identified. Possible explanations for the processing-induced changes in pharmacological effects of traditional Chinese medicines were first explored at serum pharmacochemistry level.

  3. Effect of Detoxification, Removing Stasis and Nourishing Yin Method on Corticosteroid-induced Hyperlipidemia in Patients with Systemic Lupus Erythematosus

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the effect of TCM therapy for detoxification, removing stasis, and nourishing yin on corticosteroid-induced hyperlipemia in patients with systemic lupus erythematosus (SLE), and to investigate its mechanism. Methods: One hundred and seventy patients with SLE were randomly assigned to the integrative medicine group (IM group) and the Western medicine group (WM group), 85 in each group. Also, 30 healthy subjects selected from blood donors were enrolled in the normal control (NC) group. All patients were treated mainly with prednisone,while those in the IM group were given TCM therapy additionally, and the therapeutic course for both groups was 6 successive months. The changes of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), Iow density lipoprotein cholesterol (LDL-C), very low density lipoprotein cholesterol (VLDL-C) and apolipoprotein A (ApoA) were determined and observed. A 2-year follow-up study was carried out in 16 patients of the WM group and 25 of the IM group. Results: Before treatment, no significant difference had been found among the three groups in the serum levels of lipids and lipoproteins. After the 6-month treatment, as compared with the WM group, the IM group showed lower levels of TC, TG, LDL-C, and VLDL-C (P<0.05 or P<0.01) and higher levels of HDL-C and ApoA (P<0.05). A similar effect was also shown by the follow-up study in the IM group (P<0.05 or P<0.01).Conclusion: TCM therapy for detoxification, removing stasis, and nourishing yin can effectively regulate the levels of serum lipids and lipoproteins in preventing and treating SLE patients with corticosteroidinduced hyperlipemia.

  4. 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;

    2004-01-01

    , but mainly through the vertebral plexus in the upright position. A Valsalva manoeuvre while standing completely re-opened the jugular veins. Results of ultrasound imaging of the right internal jugular vein cross-sectional area at the level of the laryngeal prominence in six healthy subjects, before......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...... and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest...

  5. 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…

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

    Directory of Open Access Journals (Sweden)

    Ana Luiza Soares Rodrigues

    2015-06-01

    Full Text Available 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 week of treatment, with two healed ulcers and a considerable increase in the amount of epithelial tissue in the wound bed.CONCLUSION: 2% papain gel demonstrated greater effectiveness in the reduction of the lesion area, but was similar to 2% carboxymethyl cellulose gel regarding the reduction in the amount of exudate and devitalized tissue. Multicenter research is suggested to evidence the effectiveness of 2% papain gel in the healing of venous ulcers. UTN number: U1111-1157-2998

  7. Standardization of care in patients with lower extremity ulcers venous etiology

    Directory of Open Access Journals (Sweden)

    Diego López Muñoz

    2012-11-01

    Full Text Available The ulcer of the lower extremity is a common chronic disease process in daily practice, in which there is wide variability in treatment. Venous ulcers account for 70% of all vascular ulcers. They occur mainly as there is a valve dysfunction as a result of venous incompetence in the lower limbs. Due to the impact they pose is necessary to apply a corrective treatment and also to demonstrate effectiveness in repairing these ulcers. Our goals are to unify and standardize criteria for action by nursing language records and all perform a standardization of care for these patients. This has been an analysis of the needs of care in patients with ulcers of the lower extremity venous etiology methodology by applying nurse. The patient assessment is made by functional health patterns of M. Gordon, for the diagnosis, interventions and outcome criteria necessary use the NNN taxonomy (NANDA-NIC-NOC. We obtained a total of 3 major diagnostic labels, encoded according to NANDA taxonomy for nursing care quality required 13 interventions. Plant 5 outcome criteria to evaluate the effectiveness and quality of nurse activity. Standardized care plans are a valuable tool. Its use ensures that share a common language, unified performance criteria, achieved quality care for our patients.

  8. 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.

  9. An unusual cause of hydrocephalus: aqueductal developmental venous anomaly

    Energy Technology Data Exchange (ETDEWEB)

    Yagmurlu, Banu; Fitoz, Suat; Atasoy, Cetin; Erden, ilhan [Ankara University School of Medicine, Department of Radiology, Ankara (Turkey); Deda, Gulhis; Unal, Ozlem [Ankara University School of Medicine, Division of Pediatric Neurology, Ankara (Turkey)

    2005-06-01

    Vascular malformations are infrequent causes of aqueductal stenoses, developmental venous anomaly (DVA) being the rarest among them. DVAs, also known as venous angiomas, are congenital in origin and characterized by dilatation of vessels in the superficial and deep venous system. Although they are usually clinically silent, they can be complicated by hemorrhage, seizures and neurologic deficits. Herein, we report MR imaging findings of a 7-year-old girl whose hydrocephalus was due to an abnormal vein coursing through the aqueduct. (orig.)

  10. Ultrasonographic evaluation of cerebral arterial and venous haemodynamics in multiple sclerosis: a case-control study.

    Directory of Open Access Journals (Sweden)

    Pasquale Marchione

    Full Text Available OBJECTIVE: Although recent studies excluded an association between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis (MS, controversial results account for some cerebrovascular haemodynamic impairment suggesting a dysfunction of cerebral autoregulation mechanisms. The aim of this cross-sectional, case-control study is to evaluate cerebral arterial inflow and venous outflow by means of a non-invasive ultrasound procedure in Relapsing Remitting (RR, Primary Progressive (PP Multiple Sclerosis and age and sex-matched controls subjects. MATERIAL AND METHODS: All subjects underwent a complete extra-intracranial arterial and venous ultrasound assessment with a color-coded duplex sonography scanner and a transcranial doppler equipment, in both supine and sitting position by means of a tilting chair. Basal arterial and venous morphology and flow velocities, postural changes in mean flow velocities (MFV of middle cerebral arteries (MCA, differences between cerebral venous outflow (CVF in clinostatism and in the seated position (ΔCVF and non-invasive cerebral perfusion pressure (CPP were evaluated. RESULTS: 85 RR-MS, 83 PP-MS and 82 healthy controls were included. ΔCVF was negative in 45/85 (52.9% RR-MS, 63/83 (75.9% PP-MS (p = 0.01 and 11/82 (13.4% controls (p<0.001, while MFVs on both MCAs in sitting position were significantly reduced in RR-MS and PP-MS patients than in control, particularly in EDSS ≥ 5 subgroup (respectively, 42/50, 84% vs. 66/131, 50.3%, p<0.01 and 48.3 ± 2 cm/s vs. 54.6 ± 3 cm/s, p = 0.01. No significant differences in CPP were observed within and between groups. CONCLUSIONS: The quantitative evaluation of cerebral blood flow (CBF and CVF and their postural dependency may be related to a dysfunction of autonomic nervous system that seems to characterize more disabled MS patients. It's not clear whether the altered postural control of arterial inflow and venous outflow is a specific MS condition or simply an

  11. Ultrasonographic Evaluation of Cerebral Arterial and Venous Haemodynamics in Multiple Sclerosis: A Case-Control Study

    Science.gov (United States)

    Marchione, Pasquale; Morreale, Manuela; Giacomini, Patrizia; Izzo, Chiara; Pontecorvo, Simona; Altieri, Marta; Bernardi, Silvia; Frontoni, Marco; Francia, Ada

    2014-01-01

    Objective Although recent studies excluded an association between Chronic Cerebrospinal Venous Insufficiency and Multiple Sclerosis (MS), controversial results account for some cerebrovascular haemodynamic impairment suggesting a dysfunction of cerebral autoregulation mechanisms. The aim of this cross-sectional, case-control study is to evaluate cerebral arterial inflow and venous outflow by means of a non-invasive ultrasound procedure in Relapsing Remitting (RR), Primary Progressive (PP) Multiple Sclerosis and age and sex-matched controls subjects. Material and Methods All subjects underwent a complete extra-intracranial arterial and venous ultrasound assessment with a color-coded duplex sonography scanner and a transcranial doppler equipment, in both supine and sitting position by means of a tilting chair. Basal arterial and venous morphology and flow velocities, postural changes in mean flow velocities (MFV) of middle cerebral arteries (MCA), differences between cerebral venous outflow (CVF) in clinostatism and in the seated position (ΔCVF) and non-invasive cerebral perfusion pressure (CPP) were evaluated. Results 85 RR-MS, 83 PP-MS and 82 healthy controls were included. ΔCVF was negative in 45/85 (52.9%) RR-MS, 63/83 (75.9%) PP-MS (p = 0.01) and 11/82 (13.4%) controls (p<0.001), while MFVs on both MCAs in sitting position were significantly reduced in RR-MS and PP-MS patients than in control, particularly in EDSS≥5 subgroup (respectively, 42/50, 84% vs. 66/131, 50.3%, p<0.01 and 48.3±2 cm/s vs. 54.6±3 cm/s, p = 0.01). No significant differences in CPP were observed within and between groups. Conclusions The quantitative evaluation of cerebral blood flow (CBF) and CVF and their postural dependency may be related to a dysfunction of autonomic nervous system that seems to characterize more disabled MS patients. It's not clear whether the altered postural control of arterial inflow and venous outflow is a specific MS condition or simply an

  12. 负压封闭引流联合含氧液冲洗对下肢慢性静脉性溃疡患者创面的影响%Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on wounds of patients with chronic venous leg ulcers

    Institute of Scientific and Technical Information of China (English)

    温皇鼎; 李志清; 张美光; 王甲汉; 王桂芳; 吴起; 童森

    2015-01-01

    Objective To evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on the growth of granulation tissue and macrophage polarization in chronic venous leg ulcers.Methods Thiry-four patients with chronic venous leg ulcers hospitalized in our department from December 2010 to July 2014 were divided into VSD group (A,n =11),VSD+irrigation group (B,n =11),and VSD + oxygen loaded fluid irrigation group (C,n =12) according to the random number table.After admission,debridement was performed,and granulation tissue in the center of the wound was harvested during the operation.After debridement,the patients in group A were treated with VSD only (negative pressure from -30 to-25 kPa,the same below) ; the patients in group B were treated with VSD combining irrigation of normal saline; the patients in group C were treated with VSD combining normal saline loaded with oxygen irrigation (flow of 1 L/min).On post treatment day (PTD) 7,the VSD devices were removed.Gross observation was conducted before debridement and on PTD 7.Ou PTD 7,the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining and Masson staining,following calculation of granulation tissue coverage rate.After debridement but before the negative pressure therapy (hereinafter referred to as before treatment) and on PTD 7,partial pressure of oxygen of the skin around the wound was measured by transcutaneous tissue oxygen tension survey meter.On PTD 7,expression of vascular endothelial growth factor (VEGF) was determined with immunohistochemistry.Before treatment and on PTD 7,cells with double positive expressions of induced nitric oxide synthase plus CD68 (type Ⅰ macrophage) and arginase 1 plus CD68 (type Ⅱ macrophage) were observed with immunofluorescence staining and quantified.Data were processed with Fisher's exact test,one-way analysis of variance,covariance analysis,paired t test,and LSD test.Results (1) The gross

  13. 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.

  14. 活血益气法对气滞血瘀证2型糖尿病大鼠治疗的实验研究%The Experiment Research on Qi Stasis Plus Blood Stasis Diabetic Rat Models with Active-blood Soup and yiqi-vein's Method

    Institute of Scientific and Technical Information of China (English)

    陈嘉斌; 柴可夫; 张副兴; 吕帅洁; 郑杨

    2011-01-01

    目的:研究活血益气法对于气滞血瘀证型2型糖尿病大鼠模型的治疗作用.方法:对大鼠用针刺激~[1]及高脂高糖饮食~[2]建立气滞血瘀证型.后给予大鼠日照并灌胃脂肪乳10日后尾静脉一次性注射四氧嘧啶(80m/kg)建立2型糖尿病模型.采用血府逐瘀汤加生黄芪怀山药进行治疗并检测指标.结果:通过血液流变学指标,血糖等客观指标分析,模型建立可靠,气滞血瘀证型2型糖尿病大鼠各指标明显好转.结论:使用针刺及高脂喂食建立模型可为将来2型糖尿病中医研究提供实验基础,活血益气法治疗气滞血瘀证2型糖尿病具有较好的疗效,但用药需谨慎配伍.%Objective: To study the effect on Qi stasis plus blood stasis diabetic rat models by Active - blood soup and yiqi - veins method. Methods:The Qi stasis plus blood stasis diabetic rat models were made by electroacupuncture stimulation and high - sugar - fat - diet. Then give them Fat Emulsion and sunlight for 10 days before injecting one - off Al-loxan monohydrate on the vein of tail. Give the treatment with Active - blood soup and yiqi - veins method and record the index. Results; According to the analysis of hemorheology indices and glucose objective index, it turns out that the models are reliable. The rats indexes improve. Conclusion Setting Qi stasis plus blood stasis diabetic rat models up will offer new experimental basis for the studies in the future. The treatment, Qi stasis plus blood stasis diabetic mellitus with Active -blood soup and yiqi -veins method,has good effectiveness,we should be careful with the traditional Medicine compatibility.

  15. [Epidemiology and management of isolated distal deep venous thrombosis].

    Science.gov (United States)

    Galanaud, J-P; Kahn, S R; Khau Van Kien, A; Laroche, J-P; Quéré, I

    2012-12-01

    Isolated distal deep-vein thromboses (DVT) are infra-popliteal DVT without involvement of proximal veins or pulmonary embolism (PE). They can affect deep calf (tibial anterior, tibial posterior, or peroneal) or muscular (gastrocnemius or soleal) veins. They represent half of all lower limbs DVT. Proximal and distal DVTs differ in terms of risk factor profile, proximal DVT being more frequently associated with chronic risk factors and distal DVT with transient ones. Their natural history (rate of spontaneous proximal extension) is debated leading to uncertainties on the need to diagnose and treat them with anticoagulant drugs. In the long term, the risk of venous thromboembolic recurrence is lower than that of proximal DVT and their absolute risk of post-thrombotic syndrome is unknown. French national guidelines suggest treating with anticoagulants for 6 weeks a first episode of isolated distal DVT provoked by a transient risk factor and treating for at least 3 months unprovoked or recurrent or active cancer-related distal DVT. The use of compression stockings use is suggested in case of deep calf vein thrombosis. Ongoing therapeutic trials should provide important data necessary to establish an evidence-based mode of care, especially about the need to treat distal DVT at low risk of extension with anticoagulants.

  16. 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

  17. 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.

  18. Daily nursing care on patients undergoing venous-venous extracorporeal membrane oxygenation: a challenging procedure!

    Science.gov (United States)

    Redaelli, Sara; Zanella, Alberto; Milan, Manuela; Isgrò, Stefano; Lucchini, Alberto; Pesenti, Antonio; Patroniti, Nicolò

    2016-12-01

    Daily nursing in critical care patients may alter vital parameters, especially in the most critically ill patients. The aim of our study was to evaluate feasibility and safety of daily nursing on patients undergoing venous-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure. Daily nursing was performed following defined phases (sponge bath, elevation with scooping stretcher, change position of endotracheal tube, dressing replacement). We recorded physiological and ECMO parameters before and during daily nursing in 5 patients for several days (total: 25 daily nursing) and adverse events: desaturation, hypertension, reduction of mixed venous oxygen saturation, arterial oxygen saturation or ECMO blood flow and elevation in minute ventilation. Sedative drug dosage and additional bolus were recorded. Daily nursing was performed in 92 % of cases (23/25), with a minimum of two adverse events per daily nursing. Hypertension and tachycardia were mostly recorded at the beginning, while desaturation, reduction in mixed venous oxygen saturation and blood flow were recorded during elevation with scooping stretcher. Increase in minute ventilation was frequent in spontaneous breathing patients. Additional bolus of sedation was required before and/or during nursing. Daily nursing significantly alters physiologic parameters; thus, it should be performed only when physicians are readily available to treat adverse events.

  19. Predictors of Venous Thromboembolic Events Associated with Central Venous Port Insertion in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Christine Hohl Moinat

    2014-01-01

    Full Text Available Insertion of central venous port (CVP catheter in the cancer population is associated with increased incidence of venous thromboembolic events (VTE. However, trials have shown limited benefit of antithrombotic treatment to prevent catheter-related venous thrombosis. This prospective observational cohort study was designed to assess the incidence of VTE closely related to CVP implantation in patients with cancer and undergoing chemotherapy, and to identify a high risk subgroup of patients. Between February 2006 and December 2011, 1097 consecutive cancer patients with first CVP implantation were included. Catheter-related VTE were defined as deep venous thrombosis in the arm, with or without pulmonary embolism (PE, or isolated PE. The incidence of CVP-associated VTE was 5.9% (IC95 4.4–7.3% at 3 months, and 11.3% (IC95 9.4–13.2% at 12 months. The incidence of any VTE was 7.6% (IC95 6.0–9.3% at 3 months, and 15.3% (IC95 13.1–17.6% at 12 months. High Khorana risk score and lung cancer were significant predictors of 3 month VTE. In conclusion, this large cohort study of patients with first CVP catheter implantation confirms the high incidence of VTE associated with the CVP implantation and allow identifying high risk patients who may benefit from thromboprophylaxis.

  20. Recent research on venous thromboembolism in China: a brief report from China Venous Thromboembolism Study Group

    Institute of Scientific and Technical Information of China (English)

    ZHAI Zhen-guo; ZHAN Xi; YANG Yuan-hua; WANG Chen

    2010-01-01

    @@ Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thrombo-embolism (PTE), carries significant mortality and morbidity. As a result of the increasing awareness and improvement in diagnostic facilities, the hospital admissions have increased dramatically in China. Recent publications have reported the increasing incidences of PTE and DVT in hospitalized patients.~(1-3)

  1. MRA for diagnosis of venous thromboembolism

    Energy Technology Data Exchange (ETDEWEB)

    Sostman, H. D. [Cornell University, Weill Medical College, Chair of Radiology, New York (United States)

    2001-12-01

    Direct imaging of pulmonary embolism (PE) and deep vein thrombosis (DVT) with CT, and potentially with MR, will continue to replace V/Q scintigraphy. Venous imaging with MR far detecting DVT is used in a few centers, and their published accuracy figures are impressive. Recent studies of MR pulmonary angiography for PE reported that sensitivity of MRA was 85-100%, specificity 95-96%, but this data must be confirmed in other centers and patient populations. MR has advantages compared with CT, which make it worthwhile to continue MR development. Ionizing radiation and iodinated contrast material are not used. Imaging the pulmonary arteries and then imaging whichever venous region is of clinical interest is practical in a single examination. Repeated examinations can be performed safely. New contrast materials will facilitate the practically and accuracy of the MR technique and perfusion imaging may increase sensitivity. MR also has disadvantages compared with CT. It does not image effectively the non-vascular compartment of the lungs. It is more expensive, patient monitoring is more cumbersome, and a routine technique, which embodies all of MR's potential advantages, has not been packaged and tested. Accordingly, helical CT is a realistic option in clinical management of patients with suspected PE in most centers, while clinical application of MR is limited to centers with appropriate MR expertise and technology. However, MR has a number of fundamental characteristics that make it potentially ideal modality for evaluating patients with suspected acute venous thromboembolic disease and further clinical research with MRA is warranted.

  2. Correlation of mixed venous and central venous oxygen saturation and its relation to cardiac index

    Directory of Open Access Journals (Sweden)

    Ramakrishna M

    2006-01-01

    Full Text Available Background and Aim: The clinical applicability of substitution of central venous oxygen saturation for mixed venous oxygen saturations in monitoring global tissue hypoxia is still a matter of controversy. Hence aim of the study is comparison of paired samples of mixed venous and central venous oxygen saturation and comparison in relation to cardiac index in varying hemodynamic conditions. Materials and Methods: Prospective clinical observation: Postoperative cardiac surgical ITU: 60 adult patients,> 18 years of age of either sex: A PAC was inserted through ® IJV, triple lumen catheter was inserted through ® IJV. Blood samples were taken from distal tip of PAC and central venous catheters. An arterial blood sample was drawn from either radial or femoral arterial line. Measurements: Continuous cardiac output monitoring. Analysis of blood samples for hemoglobin concentration and oxygen saturation. Mixed venous oxygen saturations and central venous oxygen saturations were compared. The study was carried over a period of 30h in the postoperative period and samples were taken at 6h intervals. Patients were classified into three groups as follows depending on the CI: Low (< 2.5 L/m 2, medium (2.5-4 L/m 2, high (> 4 L/m2 and correlated with Svo 2 and Scvo 2 . Results: 298 Comparative sets of samples were obtained. Svo2 was consistently lower than Scvo2 throughout the study period. The difference was statistically significant. By using Bland - Altman plot, the mean difference between Svo 2 and Scvo 2 (Svo 2 -Scvo 2 was - 2.9% ± 5.14 and confidence limits are + 7.17% and - 12.97%. The co-efficient r is > 0.7 throughout the study period for all paired samples. The correlation Svo 2 and Scvo 2 with cardiac index in all the three groups were> 0.7. Conclusion: Scvo 2 and Svo 2 are closely related and are interchangeable. Even though individual values differ trends in Scvo 2 may be substituted for trend in Svo 2

  3. Cerebral venous thrombosis: An Indian perspective

    Directory of Open Access Journals (Sweden)

    Deepa Dash

    2015-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke with extremely varied clinical presentations, predisposing factors, imaging findings, and outcomes, and thus can be extremely challenging to diagnose. Accurate and prompt diagnosis of CVT is crucial because timely and appropriate therapy can reverse the disease process and significantly reduce the risk of acute complications and long-term squel. In this article, we have reviewed the epidemiology, causative factors, clinical features, diagnosis and treatment of CVT from an Indian perspective. Over the last decade, a change in trends in the causative factors has been noted from India.

  4. Direct oral anticoagulants and venous thromboembolism

    Directory of Open Access Journals (Sweden)

    Massimo Franchini

    2016-09-01

    Full Text Available Venous thromboembolism (VTE, consisting of deep vein thrombosis and pulmonary embolism, is a major clinical concern associated with significant morbidity and mortality. The cornerstone of management of VTE is anticoagulation, and traditional anticoagulants include parenteral heparins and oral vitamin K antagonists. Recently, new oral anticoagulant drugs have been developed and licensed, including direct factor Xa inhibitors (e.g. rivaroxaban, apixaban and edoxaban and thrombin inhibitors (e.g. dabigatran etexilate. This narrative review focusses on the characteristics of these direct anticoagulants and the main results of published clinical studies on their use in the prevention and treatment of VTE.

  5. [Pain in venous thrombosis of the leg].

    Science.gov (United States)

    Henriet, J P

    1992-01-01

    According to D. Reinharez, pain and edema are the commonest presenting symptoms in phlebology. Pain is one of the most classical symptoms of an ordinary deep venous thrombosis, a valuable feature when present, in the form of deep tension, heaviness, swelling and a feeling of dead weight. It is often absent or slight. It may consist merely of a dull cramp, or of an "undefinable" (C. Bourde) odd, heavy leg. It generally affects the calf but may involve the sole of the foot, the heel, the thigh, the groin or even the true pelvis. This feeling, although "imprecise and variable" (P. Wallois, P. Griton) is highly suggestive. It increases on standing and walking in the form of unilateral uncomfortable tension, heaviness or painful swelling, which maybe a source of worry or even anxiety to the patient. Tenderness on palpation of venous tracts and their stretching is more suggestive. In the opinion of M. Duruble, Neuhof's sign (feeling of tender fullness of the calf) is more reliable than Homans' sign (pain in the calf caused by passive dorsiflexion of the foot, with the lower limb in extension) which essentially stretches only the posterior tibial venous system. The value of Sigg's sign (pain in the popliteal fossa on passive extension of the knee) is controversial. Far more rare is phlegmasia coerulea dolens or Grégoire's blue leg, complicating phlegmasia alba dolens or of sudden onset, with initial very severe or even "intolerable" pain (J.J. Pinot) in Scarpa's triangle, rapidly spreading to the limb. In varicose phlebitis (M. Perrin) or superficial thrombophlebitis or varico-phlebitis (A.A. Ramelet) or superficial venitis (J.P. Henriet), pain most often consists of moderate burning tension overlying the thrombosed vein(s), increased by palpation and mobilisation. Sometimes severe initially, it is exacerbated by the slightest touch. In total, pain, regardless of its characteristics, its site and/or its severity, is one of the most constant clinical features of venous

  6. Sickle Cell Trait Causing Splanchnic Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Priyanka Saxena

    2015-01-01

    Full Text Available Sickle cell trait is considered as a benign condition as these individuals carry only one defective gene and typically have their life span similar to the normal population without any health problems related to sickle cell. Only under extreme conditions, red cells become sickled and can cause clinical complications including hematuria and splenic infarction. Although twofold increased risk of venous thrombosis has been described in African Americans, there is no data available from Indian population. We here report a case of sickle cell trait from India whose index presentation was thrombosis of unusual vascular territory.

  7. Unilateral Pseudotumoral Presentation of Cerebral Venous Thrombosis

    Directory of Open Access Journals (Sweden)

    Leonardo Halley Carvalho Pimentel

    2014-09-01

    Full Text Available Cerebral venous thrombosis (CVT is an unusual cause of stroke. It is more common in middle-aged women and deep CVT lesions are usually bilateral. CVT can have very diverse clinical presentations and mimic other conditions. We report two women with CVT initially diagnosed as tumors (unilateral pseudotumoral presentation of CVT successfully treated with intravenous heparin. Early diagnosis was important and completely reversed the symptoms. The diagnosis of CVT should be remembered when clinical picture is compatible even if brain imaging suggests unilateral tumor.

  8. Liver CT with portal-venous contrast

    Energy Technology Data Exchange (ETDEWEB)

    Schild, H.; Mildenberger, P.; Schweden, F.; Eckmann, A.; Nagel, K.; Knuth, A.; Boerner, N.; Thelen, M.; Junginger, T.

    1987-12-01

    Contrast administration through the superior mesenteric or splenic arteries provided additional information in 22 out of 31 patients, when compared with intravenous contrast bolus for CT of the liver. In 11 patients, the demonstration of a tumour lead to a change in treatment. False positive findings occurred in four of the 31 patients. In 2 patients intrahepatic lesions were overlooked, but were found during angiography carried out at the same examination. The diagnosis of intrahepatic space-occupying lesions is discussed as well as the CT appearances of portal-venous liver perfusion.

  9. 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

  10. Detección de micrometástasis de carcinoma de colon en ganglios linfáticos

    Directory of Open Access Journals (Sweden)

    A. Roma

    2003-10-01

    Full Text Available En el carcinoma colorrectal la diseminación a los ganglios linfáticos es un factor pronóstico reconocido. La presencia de ganglios linfáticos con micrometástasis en muchos casos no puede ser detectada por técnicas rutinarias. Se estudiaron prospectivamente 162 ganglios linfáticos de 30 pacientes con carcinoma de colon, los cuales según los resultados de las técnicas rutinarias fueron clasificados como Dukes A (2, Dukes B (19 y Dukes C (9. Un paciente con enfermedad colónica benigna se uso como control negativo. Todos los ganglios se seccionaron en mitades, una de las cuales se almacenó en nitrógeno líquido para su ulterior estudio por técnicas de biología molecular, mediante la expresión del antígeno carcinoembrionario (CEA. La otra mitad fue fijada en formaldehído e incluida en parafina para su estudio anatomopatológico e inmunohistoquímico. Del total de los casos se detectó un aumento del 50% de la sensibilidad en la detección de micrometástasis mediante la reacción en cadena de la polimerasa con transcriptasa reversa (RT-PCR para los Dukes A-B y se detectó la expresión de dicho antígeno en el total de los casos Dukes C. Estos resultados evidencian una mayor sensibilidad en la detección de micrometástasis utilizando RT-PCR en comparación con las técnicas rutinarias, incluyendo la inmunohistoquímica.Dissemination of lymph nodes is a known prognostic factor in colorectal carcinoma. Micrometastases in lymph nodes can be missed when studied by routine techniques. We analyzed 162 lymph nodes from 30 patients with colonic carcinoma and using routine techniques, they were classified as follows: two Dukes A; nineteen Dukes B; and nine Dukes C. A patient with benign colon disease served as negative control. Lymph nodes were all sectioned in halves, with one of the halves stored in liquid nitrogen for molecular biology examination by carcinoembryonic antigen expression. The other formalin-fixed and paraffin embedded

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

    DEFF Research Database (Denmark)

    Feher, G; Illes, Z; Hargroves, D

    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...... and the outcome of a second event as good as that of the first one irrespective of underlying risk factors....

  12. Risk factors for a first and recurrent venous thrombosis

    NARCIS (Netherlands)

    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 treatm

  13. Central venous oxygen saturation during hypovolaemic shock in humans

    DEFF Research Database (Denmark)

    Madsen, P; Iversen, H; Secher, N H

    1993-01-01

    We compared central venous oxygen saturation and central venous pressure (CVP) as indices of the effective blood volume during 50 degrees head-up tilt (anti-Trendelenburg's position) induced hypovolaemic shock in eight healthy subjects. Head-up tilt increased thoracic electrical impedance from 31...

  14. 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)....

  15. Thrombin Avtivable Fibrinolysis Inhibitor in Venous and Arterial Thrombosis

    NARCIS (Netherlands)

    E.L.E. de Bruijne

    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

  16. Venous Thrombosis and Atherosclerosis is There a link

    Institute of Scientific and Technical Information of China (English)

    LIU MIN-JUAN; LiU Ze-lin

    2008-01-01

    @@ Venous thrombosis and arterial thrombotic disorders have long been viewed as separate pathophysiological entities, partly as a result of the obvious anatomical differences, as well as their distinct clinical presentations. Recently, the potential association between venous thromboembolism(VTE) and atherosclerosis was described for the first time in 2003. Subsequently, numerous investigations have addressed the topic.

  17. 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.

  18. Resección de metástasis hepáticas en cáncer gástrico: Experiencia preliminar

    OpenAIRE

    Díaz J,Juan Carlos; CASTILLO K,JAIME; CSENDES J,ATTILA; SAURÉ M,ALEXANDRE

    2013-01-01

    Introducción: En pacientes con cáncer gástrico y metástasis hepáticas sincrónicas, la posibilidad de tener sólo 1 a 3 metástasis es cerca de 2%, ya que, en la inmensa mayoría, corresponde a una enfermedad sistémica. Objetivos: Comunicar una experiencia preliminar que se refiere a realizar metastasectomía hepática simultánea a la gastrectomía en pacientes con cáncer gástrico. Material y Método: En estudio prospectivo, 3 de 397 pacientes tratados por cáncer gástrico que cumplían algunos criteri...

  19. Metástasis parotídea de un carcinoma renal: A propósito de un caso Parotid metastasis of renal carcinoma: A case report

    Directory of Open Access Journals (Sweden)

    Alfonso Mogedas Vegara

    2013-06-01

    Full Text Available La aparición de metástasis de un carcinoma renal a nivel parotídeo es un fenómeno poco frecuente. En la literatura indexada, solo se han descrito 29 pacientes desde 1986. Presentamos un paciente de 61 años, que tras cinco años de la realización de una nefrectomía unilateral por un carcinoma renal de células claras, desarrolló una metástasis de localización parotídea.Metastastic spread of renal cell carcinoma to the parotid gland is rare. In the indexed literature, with only 29 patients recorded since 1986. The case of a 61-year-old patient who developed parotid metastasis of renal cell carcinoma five years after unilateral nephrectomy is reported.

  20. Risk Factors for Cerebral Venous Thrombosis.

    Science.gov (United States)

    Silvis, Suzanne M; Middeldorp, Saskia; Zuurbier, Susanna M; Cannegieter, Suzanne C; Coutinho, Jonathan M

    2016-09-01

    Cerebral venous thrombosis (CVT) is a rare thrombotic disorder involving the cerebral veins and dural sinuses. In contrast to more common sites of venous thromboembolism (VTE), such as the legs and lungs, CVT mainly affects young adults and children, and women are affected three times more often than men. Although presenting symptoms are variable, headache is usually the first symptom, often in combination with focal neurologic deficits and epileptic seizures. The primary therapy for CVT consists of heparin followed by oral anticoagulation for at least 3 to 6 months. The mortality in the acute phase is 5 to 10% and a substantial proportion of survivors suffer from long-term disabilities. A large number of risk factors have been linked to CVT, although the scientific evidence for an association varies considerably between risk factors. Some risk factors, such as hereditary thrombophilia, correspond with risk factors for more common sites of VTE, whereas others, such as head trauma, are specific to CVT. In most patients, at least one risk factor can be identified. In this review, we provide an overview of the risk factors for CVT.