scholarly journals Is vein damage the only cause of clinical signs of lower limb chronic venous insufficiency?

2014 ◽  
Vol 13 (3) ◽  
pp. 162-167
Author(s):  
Amélia Cristina Seidel ◽  
Ricardo Lima Coelho ◽  
Mariana Lima Coelho ◽  
Cleusa Ema Quillici Belczak
Keyword(s):  
Doppler Ultrasonography ◽  
Venous Insufficiency ◽  
Color Doppler ◽  
Age Groups ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Obese Women ◽  
Venous Tone ◽  
Younger Age ◽  
Prevalent Disease

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.

Chronic Venous Insufficiency of the Upper Limb Due to Outflow Obstruction of Venous Access

1988 ◽  
Vol 3 (4) ◽  
pp. 265-270
Author(s):  
A. Halevy ◽  
A. Zelikovski ◽  
D. Modai ◽  
Y. Swissgarten ◽  
R. Orda
Keyword(s):  
Upper Limb ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Clinical Signs ◽  
Venous Access ◽  
Lower Limbs ◽  
Vein Thrombosis ◽  
Short Period ◽  
Cubital Fossa ◽  
Deep Vein

Two patients with angio-access for haemodialysis in whom the main venous outflow tract was thrombosed, developed severe chronic venous insufficiency (CVI) of the upper limb after a short period; one case developing a stasis ulcer of the cubital fossa. The angio-accesses were still functioning when the diagnosis was made. Treatment by surgery resulted in a dramatic regression of clinical signs of chronic venous insufficiency. CVI of the upper limb has not previously been described. CVI is a frequent and known complication after deep vein thrombosis (DVT) of the lower limbs, but never appears after DVT of the upper limbs. We describe two cases of upper limb CVI which developed as a complication of angio-access for haemodialysis treatment, and their successful treatment by surgery.

scholarly journals Dynamic Fractioning of the Gravitational Hydrostatic Pressure: A hemodynamic model for the venous pressure control by the valvo-muscular pump

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Claude Franceschi ◽  
Massimo Cappelli ◽  
José Maria Escribano ◽  
Erika Mendoza
Keyword(s):  
Hydrostatic Pressure ◽  
Fluid Mechanics ◽  
Venous Insufficiency ◽  
Venous Pressure ◽  
Clinical Signs ◽  
Lower Limbs ◽  
Instrumental Data ◽  
Basic Fluid ◽  
Hemodynamic Model ◽  
Muscular Pump

Dynamic Fractioning of the Gravitational Hydrostatic Pressure (DFGHSP) is a pillar of a hemodynamic model of the venous pathophysiology. It describes how the valvo-muscular pump varies the distal venous pressure in the lower limbs. It results from an inductive reasoning based on clinical signs and instrumental data at rest and during the action of the valvo-muscular pump of the calf. It does not claim to be the final truth, but a new "as if" model that improved the diagnosis and the treatment of the venous insufficiency (CHIVA, French acronym for Cure Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire) according to several randomized studies and meta-analyses. That approach overturns the classic diagnosis and treatment of venous insufficiency because it is conservative and opposes the widely spread destructive based view. It needs a minimal study of basic fluid mechanics which can explain venous hemodynamics, the core of venous pathophysiology. The proposed DFGHSP fluid mechanics model is compared with the hemodynamic clinical and instrumental data in order to assess its pathophysiologic relevance.

Scanning of the Sacroiliac Joint and Entheses by Color Doppler Ultrasonography in Patients with Ankylosing Spondylitis

2011 ◽  
Vol 38 (8) ◽  
pp. 1651-1655 ◽  
Author(s):  
YIZHOU HU ◽  
JIAAN ZHU ◽  
QING XUE ◽  
NIANSONG WANG ◽  
BING HU
Keyword(s):  
Ankylosing Spondylitis ◽  
Sacroiliac Joint ◽  
Doppler Ultrasonography ◽  
Activity Index ◽  
Color Doppler ◽  
Resistive Index ◽  
Lower Limbs ◽  
Active Group ◽  
Doppler Us ◽  
Inactive Group

Objective.To assess Doppler ultrasonography by comparing its detection of sacroiliitis with detection of enthesitis in patients with ankylosing spondylitis (AS).Methods.One hundred sixty-one patients with AS (according to modified New York criteria or Spondyloarthritis International Society classification criteria for axial spondyloarthritis) underwent ultrasonography (US) of the sacroiliac joint (SIJ) and major entheses of the lower limbs. Vascularization of the SIJ and morphologic changes and vascularization of entheses were observed. The resistive index of the SIJ was measured. Doppler ultrasonography examination was repeated in 20 patients by another ultrasonographer.Results.In the AS active group [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4], 90.7% of SIJ showed vascularization; this was significantly more than in the inactive group (38.5%). The resistive index of the active group in the SIJ area was significantly lower than that of the inactive group. Doppler US scanning of the SIJ was more sensitive (92.0%) than that of the entheses (52.2%). Agreement of Doppler US scanning of the SIJ and BASDAI was good, while agreement of the entheses and BASDAI was poor.Conclusion.Lower resistive index value and vascularization in the SIJ had good agreement with AS activity. Doppler US is more sensitive in detecting sacroiliitis than in detecting enthesitis.

Venous tonus enhancement after a short cycle of intermittent pneumatic compression

2008 ◽  
Vol 23 (2) ◽  
pp. 58-63 ◽  
Author(s):  
J N Harfouche ◽  
S Theys ◽  
P Hanson ◽  
J C Schoevaerdts ◽  
X Sturbois
Keyword(s):  
Venous Insufficiency ◽  
Intermittent Pneumatic Compression ◽  
Lower Limbs ◽  
Venous Tone ◽  
Short Cycle ◽  
Long Cycle ◽  
Before And After ◽  
Control Limb ◽  
Venous Diameter ◽  
The Common

Objectives To test if intermittent pneumatic compression (IPC) used with a short cycle could reproduce and confirm the 30 min vasoconstriction effect observed after a long cycle of pressure. Methods Eighteen subjects took part in the study, 12 with venous insufficiency (VI) and six without VI (NonVI). Duplex scanner was used to evaluate the diameter of six sites of veins on each of both lower limbs before and after the treatment. The IPC was applied to only one limb. Results The control limb showed no change in venous diameter. The treated limb, showed in the NonVI group one vasoconstriction: the greater saphena at the knee level (GS) ( P < 0.05). In the VI group, four sites out of six showed a vasoconstriction: the common femoral ( P < 0.005), the GS at its cross ( P < 0.001), the GS ( P < 0.001) and the lesser saphena ( P < 0.05). Conclusions Both long and short cycle of IPC are suitable to enhance the venous tone in VI patients for at least 30 min after the end of the treatment.

Completeness of West Nile virus testing in patients with meningitis and encephalitis during an outbreak in Arizona, USA

2011 ◽  
Vol 140 (9) ◽  
pp. 1632-1636 ◽  
Author(s):  
I. B. WEBER ◽  
N. P. LINDSEY ◽  
A. M. BUNKO-PATTERSON ◽  
G. BRIGGS ◽  
T. J. WADLEIGH ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Severe Disease ◽  
Age Groups ◽  
Clinical Signs ◽  
Public Health Education ◽  
West Nile ◽  
Neuroinvasive Disease ◽  
Younger Age ◽  
And Control ◽  
Virus Testing

SUMMARYAccurate data on West Nile virus (WNV) cases help guide public health education and control activities, and impact regional WNV blood product screening procedures. During an outbreak of WNV disease in Arizona, records from patients with meningitis or encephalitis were reviewed to determine the proportion tested for WNV. Of 60 patients identified with meningitis or encephalitis, 24 (40%) were tested for WNV. Only 12 (28%) of 43 patients aged <50 years were tested for WNV compared to 12 (71%) of 17 patients aged ⩾50 years (P<0·01). Patients with clinical signs of weakness or paralysis, elevated CSF protein, admitted to an inpatient facility, or discharged to a rehabilitation facility were also more likely to have WNV testing performed. The lack of testing in younger age groups and in those with less severe disease probably resulted in substantial underestimates of WNV neuroinvasive disease burden.

scholarly journals Is it always DVT? evaluation of leg swelling with color Doppler Sonography

2016 ◽  
Vol 11 (3) ◽  
Author(s):  
Sadaf Batool ◽  
Asim Shaukat ◽  
Khawaja Khurshid Ahmad ◽  
Tahir Qadeer Khan ◽  
Afshan Qureshi ◽  
...  
Keyword(s):  
Doppler Ultrasonography ◽  
Doppler Sonography ◽  
Color Doppler ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Colour Doppler Sonography ◽  
Vein Thrombosis ◽  
Duplex Imaging ◽  
Deep Vein

Objective: The aim of this study was to assess the value of duplex ultrasound examination in establishing diagnosis in swollen lower limbs. Setting: This study was conducted at the Department of Diagnostic radiology Mayo hospital Lahore. Method: 50 consecutive patients presenting with leg swelling, submitted for colour Doppler sonography of the lower extremities were examined for deep vein thrombosis (DVT). Results: 46% of the patients were detected as having DVT , when examined through Doppler Ultrasonography. While 28% of the patients were not having any pathology in the limb.26% of the patients were having pathology other than DVT. Conclusion: The veins of the calf muscles are a common site of acute DVT and a source of pulmonary embolism. They should always be investigated in patients with leg swelling. Complete venous evaluation with duplex imaging can be very helpful in determination of underlying cause of the swelling.

Inequalities and Impact of Socioeconomic-Cultural Factors in Suicide Rates Across Italy

Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Monica Vichi ◽  
Maria Masocco ◽  
Nicola Vanacore ◽  
...  
Keyword(s):  
Suicide Rate ◽  
Age Groups ◽  
Premature Death ◽  
Mortality Rates ◽  
Mortality Data ◽  
Italian Population ◽  
Comprehensive Overview ◽  
Suicide Rates ◽  
Younger Age ◽  
Age And Sex

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.

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