Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with o...Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with older age, smoking, lower extremity trauma, presence of an arteriovenous shunt, and elevated estrogen levels. All patients should be initially treated with conservative management. Venoactive drugs like calcium dobesilate are useful. Objectives: The primary objective compared the clinical improvement in patients with CVI, grades 0 - 3 of the CEAP classification of chronic venous disease, produced by two formulations of calcium dobesilate: calcium dobesilate LP 1 g OD vs calcium dobesilate 500 mg BID, immediate release. The secondary objective assessed the side effects of both formulations. Method: All patients took one tablet and one capsule at 7 am, and one capsule at 7 pm, for 8 weeks. One group received dobesilate 1 g OD and the other group received dobesilate 500 md BID. They were evaluated after 15, 30 and 60 days of treatment, using the symptom evaluation scale. Results: In both groups, there was a significant decrease in the symptom score after 15 days. Four patients in the Dobesilate OD group: had adverse effects, which did not require suspension of treatment. In the BID dobesilate group, there was one therapeutic failure, and one case of gastric discomfort. Conclusions: Prolonged-release Calcium dobesilate 1 g OD is as effective as calcium dobesilate 500 mg BID for the treatment of patients with chronic venous insufficiency.展开更多
Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is cruc...Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes.展开更多
Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his his...Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his history, we can note a gunshot wound to the right leg. Ultrasonography and CT angiography helped in the diagnosis of traumatic arteriovenous fistula. The patient underwent a fistula embolization which allowed the wound to heal. The clinical presentation, additional examinations and the latest treatment recommendations will be discussed in this article.展开更多
Chronic venous insufficiency is characterized by high incidence,difficult treatment and high recurrence rate.Traditional Chinese Medicine Preventive Treatment Theory is one of the important core contents in the theory...Chronic venous insufficiency is characterized by high incidence,difficult treatment and high recurrence rate.Traditional Chinese Medicine Preventive Treatment Theory is one of the important core contents in the theory of TCM.By using the theory of Traditional Chinese Medicine Preventive Treatment,using the theory of“prevention before illness,prevention the disease continues to change and prevention repeated when the disease has been cured”,can reduce the incidence rate effectively,improve the effect of clinical treatment,it is also to enrich and develop the theory of Traditional Chinese Medicine Preventive Treatment.展开更多
This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryothera...This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryotherapy ulcer prevention treatment. Fifty-seven individuals participated in the randomized clinical trial;28 in the experimental group and 29 received usual care only. Results revealed no statistically significant differences between the experimental and usual care groups although AROM measures in the experimental group showed a consistent, non-clinically relevant decrease compared to the usual care group except for dorsiflexion. Within treatment group comparisons of VRT results showed a statistically significant increase in both dorsiflexion and plantar flexion for patients with severe VRT in the experimental group (6.9 ± 6.8;p = 0.002 and 5.8 ± 12.6;p = 0.02, respectively). Cryotherapy did not further restrict already compromised AROM, and in some cases, there were minor improvements.展开更多
目的探讨联合血栓弹力图(thromboelastography,TEG)、凝血指标和血小板参数评估慢性静脉功能不全(chronic venous insufficiency,CVI)患者血栓形成风险的预测价值。方法回顾性纳入本院2020年11月至2022年3月共计CVI患者359名,根据是否...目的探讨联合血栓弹力图(thromboelastography,TEG)、凝血指标和血小板参数评估慢性静脉功能不全(chronic venous insufficiency,CVI)患者血栓形成风险的预测价值。方法回顾性纳入本院2020年11月至2022年3月共计CVI患者359名,根据是否发生静脉血栓栓塞症(venous thromboembolism,VTE)分为VTE组和非VTE组。分析2组的基线特征,以及联合血栓弹力图、凝血指标和血小板参数对CVI患者发生VTE的风险预测价值。采用单因素Logistic回归分析的方筛选风险因子,采用多因素Logistic回归构建预测模型,通过曲线下面积(AUC)、灵敏度、特异度等指标以及临床决策曲线(DCA)进行模型性能评价。结果对照组相比,血栓形成组R值降低(3.27±0.71 vs 3.87±1.16,P<0.05);凝血酶原时间(PT)降低(11.08±3.02 vs 12.86±3.48,P<0.001),纤维蛋白原(Fib)增高(3.46 vs 3.10,P<0.05),D二聚体(DD)增高(3.00 vs 1.12,P<0.001);血小板分布宽度(PDW)降低(12.01±3.87 vs 13.98±3.20,P<0.001)。以PT、DD、R值、Fib和PDW作为预测因子建立的血栓形成预测模型ROC曲线下面积为0.8422,灵敏度和特异度分别为36.78%和95.59%。临床决策曲线(DCA)判断当模型预测值为0.1~0.7时可使患者获益。结论联合TEG、凝血指标和血小板参数预测CVI患者发生VTE风险具有一定的效果。展开更多
Background: Chronic venous insufficiency (CVI) is a widespread and underdiagnosed condition that affects more than 20% of the general population. The most prevalent manifestation of CVI is varicose veins (VVs), which ...Background: Chronic venous insufficiency (CVI) is a widespread and underdiagnosed condition that affects more than 20% of the general population. The most prevalent manifestation of CVI is varicose veins (VVs), which affect up to 25% of women and 15% of males. Sclerotherapy is a minimally invasive procedure used primarily in treating telangiectasias, reticular veins, and small varicose veins. Objectives: This study aims to evaluate the efficacy and safety of various sclerotherapy techniques in treating varicose veins-related complications. Methods: We conducted a cross-sectional observational interventional study at Jordan University Hospital (JUH) from September 2022 to January 2023. The study involved patients with lower limb varicose veins, assessing their clinical response and monitoring potential treatment complications. Statistical analyses were performed using SPSS software version 21.0. Results: Of 567 patients with diagnosed VVs, 544 were female (95.94%), and 23 were male (4.06%). The primary complaints were pain and cosmetic concerns. Treatments included Foam Aethoxysklerol® 3% (polidocanol) and Micro-foam Aethoxysklerol® 1%. Improvement in symptoms was reported by 538 patients (94.89%). The most common adverse event was hyperpigmentation, reported in 120 patients (21.16%), followed by post-procedural pain in 104 patients (18.34%). Notably, one patient (0.18%) experienced deep vein thrombosis (DVT), one (0.18%) reported telangiectatic matting, and there were two cases (0.36%) of visual disturbances and one allergic reaction. Conclusion: Sclerotherapy is effective and safe for treating VVs with minimal adverse events. It is a viable standalone treatment, reducing complications linked to other methods like radiofrequency ablation and surgery.展开更多
Venous ulceration is the most severe and debilitating outcome of chronic venous insufficiency in the lower limbs and accounts for 80 percent of lower extremity ulcerations. The morbidity caused by them has a serious i...Venous ulceration is the most severe and debilitating outcome of chronic venous insufficiency in the lower limbs and accounts for 80 percent of lower extremity ulcerations. The morbidity caused by them has a serious impact on the quality of life. Sustained venous hypertension, caused by venous insufficiency leads to venous ulceration. The diagnosis is mainly clinical but needs to be differentiated from other causes of lower limb ulcers. Doppler ultrasound is the diagnostic investigation. Treatment options for venous ulcers include conservative management, mechanical treatment, medications, and surgical options. The goals of treatment are to reduce edema, improve ulcer healing, and prevent recurrence. The achievement of good long term results depends on continuous care, ulcer care clinics, home health nursing and regular evaluation by the doctor. They have a crucial role to play for the amelioration of this common and morbid condition.展开更多
文摘Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with older age, smoking, lower extremity trauma, presence of an arteriovenous shunt, and elevated estrogen levels. All patients should be initially treated with conservative management. Venoactive drugs like calcium dobesilate are useful. Objectives: The primary objective compared the clinical improvement in patients with CVI, grades 0 - 3 of the CEAP classification of chronic venous disease, produced by two formulations of calcium dobesilate: calcium dobesilate LP 1 g OD vs calcium dobesilate 500 mg BID, immediate release. The secondary objective assessed the side effects of both formulations. Method: All patients took one tablet and one capsule at 7 am, and one capsule at 7 pm, for 8 weeks. One group received dobesilate 1 g OD and the other group received dobesilate 500 md BID. They were evaluated after 15, 30 and 60 days of treatment, using the symptom evaluation scale. Results: In both groups, there was a significant decrease in the symptom score after 15 days. Four patients in the Dobesilate OD group: had adverse effects, which did not require suspension of treatment. In the BID dobesilate group, there was one therapeutic failure, and one case of gastric discomfort. Conclusions: Prolonged-release Calcium dobesilate 1 g OD is as effective as calcium dobesilate 500 mg BID for the treatment of patients with chronic venous insufficiency.
基金Supported by The National Research Foundation of Korea Grant Funded by The Korea Government(MSIT),No.00219725.
文摘Pain is a common complaint among patients seeking medical care.If left un-treated,pain can become chronic,significantly affecting patients’quality of life.An accurate diagnosis of the underlying cause of pain is crucial for effective treatment.Chronic venous insufficiency(CVI)is frequently overlooked by pain physicians.Moreover,many pain physicians lack sufficient knowledge about CVI.CVI is a common condition resulting from malfunctioning or damaged valves in lower limb veins.Symptoms of CVI,ranging from mild to severe,include pain,heaviness,fatigue,itching,swelling,skin color changes,and ulcers in the lower limbs.Recently,it has become more widely known that these symptoms can be attributed to CVI.Even slight or mild CVI can cause related symptoms.Pain physicians primarily consider neuromusculoskeletal disorders when assessing patients with leg pain,and often neglect the possibility of CVI.In clinical practice,when pain physicians encounter patients with unresolved leg pain,they must assess whether the patients exhibit symptoms of CVI and conduct tests to differ-entiate CVI from other potential causes.
文摘Chronic lower limb wounds are common. They can be of arterial or venous origin. In this article, we will present a clinical case of a 30-year-old patient with a chronic injury to the right medial malleolus. In his history, we can note a gunshot wound to the right leg. Ultrasonography and CT angiography helped in the diagnosis of traumatic arteriovenous fistula. The patient underwent a fistula embolization which allowed the wound to heal. The clinical presentation, additional examinations and the latest treatment recommendations will be discussed in this article.
基金Beijing innovation cultivation research funding project for biomedicine and life science(No.Z151100003915132)The youth project of national natural science foundation(No.81804095)。
文摘Chronic venous insufficiency is characterized by high incidence,difficult treatment and high recurrence rate.Traditional Chinese Medicine Preventive Treatment Theory is one of the important core contents in the theory of TCM.By using the theory of Traditional Chinese Medicine Preventive Treatment,using the theory of“prevention before illness,prevention the disease continues to change and prevention repeated when the disease has been cured”,can reduce the incidence rate effectively,improve the effect of clinical treatment,it is also to enrich and develop the theory of Traditional Chinese Medicine Preventive Treatment.
文摘This study compared ankle range of motion (AROM) including dorsiflexion, plantar flexion, inversion and eversion, and venous refill time (VRT) in leg skin inflamed by venous disorders, before and after a new cryotherapy ulcer prevention treatment. Fifty-seven individuals participated in the randomized clinical trial;28 in the experimental group and 29 received usual care only. Results revealed no statistically significant differences between the experimental and usual care groups although AROM measures in the experimental group showed a consistent, non-clinically relevant decrease compared to the usual care group except for dorsiflexion. Within treatment group comparisons of VRT results showed a statistically significant increase in both dorsiflexion and plantar flexion for patients with severe VRT in the experimental group (6.9 ± 6.8;p = 0.002 and 5.8 ± 12.6;p = 0.02, respectively). Cryotherapy did not further restrict already compromised AROM, and in some cases, there were minor improvements.
文摘目的探讨联合血栓弹力图(thromboelastography,TEG)、凝血指标和血小板参数评估慢性静脉功能不全(chronic venous insufficiency,CVI)患者血栓形成风险的预测价值。方法回顾性纳入本院2020年11月至2022年3月共计CVI患者359名,根据是否发生静脉血栓栓塞症(venous thromboembolism,VTE)分为VTE组和非VTE组。分析2组的基线特征,以及联合血栓弹力图、凝血指标和血小板参数对CVI患者发生VTE的风险预测价值。采用单因素Logistic回归分析的方筛选风险因子,采用多因素Logistic回归构建预测模型,通过曲线下面积(AUC)、灵敏度、特异度等指标以及临床决策曲线(DCA)进行模型性能评价。结果对照组相比,血栓形成组R值降低(3.27±0.71 vs 3.87±1.16,P<0.05);凝血酶原时间(PT)降低(11.08±3.02 vs 12.86±3.48,P<0.001),纤维蛋白原(Fib)增高(3.46 vs 3.10,P<0.05),D二聚体(DD)增高(3.00 vs 1.12,P<0.001);血小板分布宽度(PDW)降低(12.01±3.87 vs 13.98±3.20,P<0.001)。以PT、DD、R值、Fib和PDW作为预测因子建立的血栓形成预测模型ROC曲线下面积为0.8422,灵敏度和特异度分别为36.78%和95.59%。临床决策曲线(DCA)判断当模型预测值为0.1~0.7时可使患者获益。结论联合TEG、凝血指标和血小板参数预测CVI患者发生VTE风险具有一定的效果。
文摘Background: Chronic venous insufficiency (CVI) is a widespread and underdiagnosed condition that affects more than 20% of the general population. The most prevalent manifestation of CVI is varicose veins (VVs), which affect up to 25% of women and 15% of males. Sclerotherapy is a minimally invasive procedure used primarily in treating telangiectasias, reticular veins, and small varicose veins. Objectives: This study aims to evaluate the efficacy and safety of various sclerotherapy techniques in treating varicose veins-related complications. Methods: We conducted a cross-sectional observational interventional study at Jordan University Hospital (JUH) from September 2022 to January 2023. The study involved patients with lower limb varicose veins, assessing their clinical response and monitoring potential treatment complications. Statistical analyses were performed using SPSS software version 21.0. Results: Of 567 patients with diagnosed VVs, 544 were female (95.94%), and 23 were male (4.06%). The primary complaints were pain and cosmetic concerns. Treatments included Foam Aethoxysklerol® 3% (polidocanol) and Micro-foam Aethoxysklerol® 1%. Improvement in symptoms was reported by 538 patients (94.89%). The most common adverse event was hyperpigmentation, reported in 120 patients (21.16%), followed by post-procedural pain in 104 patients (18.34%). Notably, one patient (0.18%) experienced deep vein thrombosis (DVT), one (0.18%) reported telangiectatic matting, and there were two cases (0.36%) of visual disturbances and one allergic reaction. Conclusion: Sclerotherapy is effective and safe for treating VVs with minimal adverse events. It is a viable standalone treatment, reducing complications linked to other methods like radiofrequency ablation and surgery.
文摘Venous ulceration is the most severe and debilitating outcome of chronic venous insufficiency in the lower limbs and accounts for 80 percent of lower extremity ulcerations. The morbidity caused by them has a serious impact on the quality of life. Sustained venous hypertension, caused by venous insufficiency leads to venous ulceration. The diagnosis is mainly clinical but needs to be differentiated from other causes of lower limb ulcers. Doppler ultrasound is the diagnostic investigation. Treatment options for venous ulcers include conservative management, mechanical treatment, medications, and surgical options. The goals of treatment are to reduce edema, improve ulcer healing, and prevent recurrence. The achievement of good long term results depends on continuous care, ulcer care clinics, home health nursing and regular evaluation by the doctor. They have a crucial role to play for the amelioration of this common and morbid condition.
