Effektivität der Sklerosierungstherapie in Abhängigkeit vom Alter der Patienten

Phlebologie ◽  
2010 ◽  
Vol 39 (04) ◽  
pp. 202-207
Author(s):  
K. Denk ◽  
D. Schliephake ◽  
A. Recke ◽  
B. Kahle

SummaryIn clinical practice sclerotherapy of intradermal varicose veins seems to be more effective in elderly patients. Patients, methods: After prior duplex-sonographic investigation 48 patients with intradermal varicose veins (diameter 1–2 mm, C1,EP, AS, PR) were included. 24 patients (group 1) received Polidocanol (0.25% Aethoxysklerol®) injection sclerotherapy and 24 patients (group 2) received sodium chloride injections. In all subjects an area of 100 square centimetres of the lower limb was treated. The borders of each area were marked and photo documented. The injections were performed by an examiner who was unaware of which liquid had been injected. Compression therapy was performed for one week after the treatment. One and four weeks later the results were controlled by the physician who performed the injections and documented by an independent photographer. The glossy prints of the areas before and four weeks after the treatment were sent to two blinded independent external reviewers. The reviewers noted their evaluation on a visual analogue scale (VAS). The reviewers received each anonymous photodocument twice within 3 weeks. Results: The VAS of both experts showed a significant difference between the results in group 1 and group 2 (p < 0.0001). Median of efficacy was 58.5% in group 1 (verum) and 0.5% in group 2 (placebo). Both experts had a stable intraindividual reliability of 85% and further both raters didn´t differ concerning their ratings. In group 1 (verum) the Pearson correlation coefficient showed a significant correlation between the therapeutic outcome and the age of the treated patients. Conclusions: Injection sclerotherapy of intradermal varicose veins using 0.25 %Polidocanol (Aethoxysklerol) is an efficient treatment that leads to a good aesthetic outcome. In elderly patients sclerotherapy is more efficient.

Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 13-17
Author(s):  
J. Duben ◽  
J. Gatek ◽  
T. Saha ◽  
G. Hnatkova ◽  
L. Hnatek

SummaryIntroduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too.Aim: The aim of this study was to use endo -vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries.Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with CelonProSurge micro and 18W for usage of Celon ProCurve probe.Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group.Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins.


2021 ◽  
Vol 67 (3) ◽  
pp. 45-54
Author(s):  
N. O. Khovasova ◽  
A. V. Naumov ◽  
O. N. Tkacheva ◽  
E. N. Dudinskaya

BACKGROUND: Older adults with osteoporosis (OP) and high risk of falls are the most vulnerable group of patients with respect to the development of fractures. Falls and fractures in elderly patients with OP are associated with geriatric syndromes and worse functional status.AIM: To аssess comorbidity and geriatric status in elderly and senile patients with and without OP.MATERIALS AND METHODS: The study included 607 patients over 60 years of age hospitalized in the geriatric department. According to the presence of OP, the patients were divided into 2 groups: group 1 — patients with OP (n=178, 29.3%), group 2 — patients without OP (n=429, 70.7%). All patients underwent a general clinical study, an assessment of comorbidity ­according to the Charlson index, and a comprehensive geriatric score.RESULTS: OPs had 178 (29.3%) patients, more often these were women. 55.6% of patients with OP were disabled. Age-­related diseases such as Alzheimer’s disease, Parkinson’s disease, osteoarthritis, anemia, thyroid disease, varicose veins were significantly more common in patients with OP. With almost all of these diseases, a univariate analysis revealed an association with OP. Geriatric syndromes such as frailty, hypodynamia, malnutrition, polypharmacy, urinary incontinence were significantly more common in group 1 patients. Patients with OP were more likely to live alone and use mobility aids compared to patients without OP.The univariate analysis demonstrated that OP is associated (OR 1.54 to 2.00) with frailty, hypodynamia, the use of aids in movement, sleep disorders, sensory vision deficiency, urinary incontinence. The Functional status of patients with OP was worse compared to patients without OP. Patients with OP suffered more fractures, and vertebral fractures were significantly more frequent.CONCLUSION: Patients with OP have a high comorbidity, a burdened geriatric status. In elderly patients, it is necessary not only to screen and diagnose OP, to assess the risk of 10-years probability of major pathological fractures using the FRAX algorithm, but also to conduct a comprehensive geriatric assessment to diagnose geriatric syndromes that weaken the course of OP and lead to more serious consequences.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jung-Hsuan Cheng ◽  
Chun-Feng Chen ◽  
Ping-Ho Chen ◽  
Kun-Jung Hsu ◽  
Han-Sheng Chen ◽  
...  

Purpose. This study explored the effects of genioplasty (Gep) and anterior subapical osteotomy of the maxilla and mandible (ASOMx+ASOMd) on the pharyngeal airway dimensions of patients with bimaxillary protrusion (BiP). Method. Thirty-two patients were divided into 2 groups. Group 1 received ASOMx+ASOMd, and group 2 received ASOMx+ASOMd+Gep. The cephalograms of the patients were collected before surgery and 2 months after surgery. Changes in the landmarks, related cephalometric angles (gonial, SN-GoGn, Y -axis, and SN-C2C4 angles), and 2 pharyngeal airway dimensions (uvulo-pharyngeal airway [UOP] and tongue–pharyngeal airway [TOP]) were analyzed. Results. Before surgery, the parameters (incisor superius, incisor inferius, menton, most superior and anterior point of the hyoid bone, tip of the uvula, inferoanterior point on the second cervical vertebra, and inferoanterior point on the fourth cervical vertebra) and measured angles (SNA, SNB, ANB, gonial, SN-GoGn, Y -axis, and C4C2-SN) of both groups showed no significant differences. Following ASOMx, the patients in groups 1 and 2 exhibited a setback by 7.0 and 6.6 mm, respectively. After ASOMd, groups 1 and 2 exhibited 4.9 and 5.3 mm setbacks, respectively. No significant difference in the amount of setback was observed between groups 1 and 2. The postoperative horizontal and vertical positions of Me in group 2 were significantly forward by 6.1 mm and upward by 1.5 mm, respectively. Regarding pharyngeal airway dimensions, TOP was decreased in group 1 (1.7 mm) and group 2 (1.3 mm). In the postoperative Pearson correlation coefficient test, the horizontal and vertical positions of Me showed no significant correlation with TOP in both groups. Therefore, Gep did not prevent the reduction of TOP in group 2. Conclusion. After bimaxillary anterior subapical osteotomy, the TOP of patients with BiP was decreased, and this situation was unavoidable, regardless of whether Gep was performed.


VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.


2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.


MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 14-24

The clinic and diagnostics of tuberculosis meningitis (TM) in 926 patients treated in St. Petersburg hospitals in 1965–1994 (group 1) and in 1995–2018 (group 2) is presented. The TM clinic is demonstrated to be determined by the form of tuberculosis and its characteristic generalization nature in the presence of repeated waves of bacteremia and allergic vasculitis of greater or lesser severity. There is clinical peculiarity of TM in primary pulmonary tuberculosis and its early large-focal and late miliar generalization, as well as in hematogenous tuberculosis. In patients of the 1st and 2nd groups the TM clinic shows in some respects a noticeable similarity, in others — a significant difference. Despite the typical symptoms, early diagnosis of TM took place in less than 20% of patients. Clinical examples illustrating the unusual development of TM, contrasting with its usual course, are given. A number of objective and subjective factors contributing to the adverse evolution of TM and its lethal outcome are discussed. These include the peculiarity of modern tuberculosis, especially when associated with HIV infection, as well as medical errors associated with ignorance of the pathogenesis of tuberculosis and failure to comply with the minimum examination for tuberculosis.


2019 ◽  
Vol 70 (7) ◽  
pp. 2608-2613
Author(s):  
Larisa Simona Deac ◽  
Kamel Earar ◽  
Adela Loredana Colceriu Burtea ◽  
Alexandra Stefania Berghe ◽  
Aurora Antoniac ◽  
...  

This study evaluates and compares by dye penetration method and SEM photomicrographs the sealing obtained using two different classes of adhesive systems (etch-and-rinse and self-etch with selective etching) with SDR (Dentsply) bulk fill composite. 84 class V cavities were prepared on oral and vestibular face of 42 intact, freshly extracted wisdom teeth. The cavities were randomly divided in two groups and restored: Group 1 with prime &bond one select (Dentsply) and SDR (Dentsply) and Group 2 with prime&bond one Etch&Rinse (Dentsply) and SDR (Dentsply). Prime&bond one Select (Dentsply) is a single component adhesive and can be used in self etch mode, in selective enamel etch mode, or in etch-and-rinse mode. We chosen for this study the selective etch of the enamel mode. Prime&bond one Etch Rinse (Dentsply) is a universal etch-and-rinse one-bottle dental adhesive, designed to be used in two steps. The bulk fill composites are commonly used in modern dentistry due to their properties of low polymerization shrinkage and curing in layer of 4 mm depth, offering the practitioner a fast clinical procedure with good results. The results showed a good sealing at enamel and dentin margins with no statistically significant difference between adhesives, even though the mean of enamel infiltration was smaller for Group1. Furthermore the results show that there were differences between the two groups, for the infiltrations at the enamel, the values of microleakage being arithmetically higher for Group 1, but with no statistically difference between the two groups.SEM images showed for both groups a good adhesion surface with the tooth, but the hybrid layer of the total-etch adhesives is different from the hybrid layer formed by self etch adhesives, in terms of thickness, uniformity. In conclusion both adhesive systems have equivalent sealing qualities and can be successfully used with SDR.


2020 ◽  
Author(s):  
Guy Tobias ◽  
Assaf B Spanier

BACKGROUND Gingivitis is a non-painful, inflammatory condition that can be treated with home remedies. Left untreated gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. In order to contain the spread of the corona virus, governments, including in Israel, have restricted movements of their citizens which has caused routine dental checkups to be postponed. OBJECTIVE This study aimed to examine the ability of an mHealth app- iGAM to reduce gingivitis. METHODS A prospective observational cohort study was performed, 160 unpaid participants were divided into 2 equal groups and downloaded the iGAM app. Group 1 photographed their gums weekly for eight weeks. Group 2 photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the message "It is recommended to read the information contained within the app regarding maintaining oral hygiene habits". A single blinded researcher examined the images and scored them according to the Modified Gingival Index (MGI). RESULTS The average age of group 1 was 26.77 (S.D. ± 7.43), and 28.53 (S.D. ± 10.44) for group 2. The majority were male (74.7% in group 1 vs. 66.7% in group 2), most participants described themselves as "secular", most were "single", non-smokers (74.7% vs. 78.4%) and did not take medications (85.3% vs. 78.4%). 126 subjects completed the study. A statistically significant difference (P <.001) was found in the dependent variable (MGI) in a linearly negative manner. As time passed, the gum condition improved, there were significantly lower gingivitis scores in group 1 (M = 1.16, S.D. ± 1.18) compared to group 2 (M = 2.16, S.D. ± 1.49), after eight weeks. Those with more recent dental visits had a lower MGI (p = .037). No association was found between knowledge and behavior, most participants were familiar with the recommendations for maintaining oral health, yet they only performed some. CONCLUSIONS A dental selfie taken once a week using an mHealth app (iGAM) reduced the signs of gingivitis and promoted oral health. During the current pandemic where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health. CLINICALTRIAL The protocol was approved by Hadassah research ethics committee (IRB, 0212-18-HMO)


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Daniele Tognetto ◽  
Chiara De Giacinto ◽  
Alberto Armando Perrotta ◽  
Tommaso Candian ◽  
Alessandro Bova ◽  
...  

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.


2021 ◽  
Vol 28 (3) ◽  
pp. 328-338
Author(s):  
Ogbutor Udoji Godsday ◽  
Nwangwa Eze Kingsley ◽  
Nwogueze Bartholomew Chukwuebuka ◽  
Chukwuemeka Ephraim ◽  
Ezunu Emmanuel ◽  
...  

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.


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