Lower Extremity Blood Flow Velocity in Obese versus Nonobese Pregnant Women

2019 ◽  
Vol 37 (04) ◽  
pp. 384-389 ◽  
Author(s):  
Eryn H. Dutta ◽  
Ralph N. Burns ◽  
Luis D. Pacheco ◽  
Caroline C. Marrs ◽  
Aristides Koutrouvelis ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Pregnant Women ◽  
Lower Extremities ◽  
Duplex Ultrasound ◽  
Volume Flow ◽  
Venous Stasis ◽  
Chi Square ◽  
Mean Velocity ◽  
Venous Flow ◽  
Increased Risk

Objective Obesity and pregnancy are risk factors for venous thromboembolism (VTE). In nonpregnant individuals, abdominal obesity is associated with venous insufficiency. This study aimed to compare venous Doppler volume flow and velocity in the lower extremities of obese versus nonobese women. Study Design A prospective cohort study was performed. Duplex ultrasound examined bilateral lower extremity venous flow and velocity (time-averaged mean velocity, TAMV). Flow was analyzed at the superficial femoral (SFV), distal external iliac (DEI), common femoral, profunda femoris, and popliteal veins. Mann–Whitney U-test, Spearman's correlation, and chi-square tests were used, with a significance of p < 0.05. Results Left SFV TAMV and volume flow were higher in the obese group (5.1 [4.1–5.7] vs. 2.8 [1.7–3.4] cm/second; p < 0.001) and (89 [73–119] vs. 48 [26–62] cm/minute; p = 0.005). Significant differences were noted for right DEI flow (obese 326 [221–833] vs. nonobese 182 [104–355] cm/minute; p = 0.049). The right femoral profunda flow was also higher in obese (49 [40–93] cm/minute) compared with nonobese (31 [22–52] cm/minute; p = 0.041). Conclusion Volume flow and TAMV in the lower extremities of obese gravidas are higher compared with nonobese ones. Thus, the increased risk of VTE among obese pregnant women may not be caused by venous stasis.

scholarly journals Pendidikan Kesehatan dengan Pendekatan Model Information Motivation Behavior Skill (IMB) terhadap Peningkatan Pengetahuan dan Pola Konsumsi Sayur dan Buah pada Ibu Hamil

2019 ◽  
Vol 10 (3) ◽  
pp. 320
Author(s):  
Farhati Farhati ◽  
Riska Resmana ◽  
Dian Nurhadianti
Keyword(s):  
Health Education ◽  
Pregnant Women ◽  
Consumption Patterns ◽  
P Value ◽  
Chi Square ◽  
Increased Risk ◽  
Post Test ◽  
Quasi Experimental ◽  
Chi Square Test ◽  
Vegetables And Fruits

<p>Low consumption of vegetables and fruit causes an increased risk of chronic diseases such as cancer, heart disease, and diabetes. The results showed that the majority of pregnant women (52.9%) rarely consume vegetables and fruit in sufficient quantities as recommended. Therefore, it is necessary to provide education about the importance of vegetables and fruits consumption, one of which is through the Information Motivation Behavioral Skill (IMB) approach. This study aims to determine the effect of health education with the Information Motivation Behavior Skill (IMB) approach to increasing knowledge and consumption patterns of vegetables and fruits in pregnant women. This research is a quasi-experimental study with pre-post test design with control groups conducted in pregnant women in the city of Bandung with 60 samples using the observation sheet and questionnaire instruments. Data analysis used the chi-square test. The result of this study indicates that there are significant differences in knowledge and patterns of consumption of vegetables and fruit in pregnant women between the control and treatment groups with a p-value&lt;0.05. Information Motivation Behavior Skill (IMB) Health Education Model approach has a role in increasing the knowledge and consumption patterns of vegetables and fruits in pregnant women.</p>

scholarly journals Molecular Imaging of Lower Extremity Peripheral Arterial Disease: An Emerging Field in Nuclear Medicine

2022 ◽  
Vol 8 ◽  
Author(s):  
Mitchel R. Stacy
Keyword(s):  
Nuclear Medicine ◽  
Molecular Imaging ◽  
Peripheral Arterial Disease ◽  
Lower Extremity ◽  
Lower Extremities ◽  
Arterial Disease ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Increased Risk ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is an atherosclerotic disorder of non-coronary arteries that is associated with vascular stenosis and/or occlusion. PAD affecting the lower extremities is characterized by a variety of health-related consequences, including lifestyle-limiting intermittent claudication, ulceration of the limbs and/or feet, increased risk for lower extremity amputation, and increased mortality. The diagnosis of lower extremity PAD is typically established by using non-invasive tests such as the ankle-brachial index, toe-brachial index, duplex ultrasound, and/or angiography imaging studies. While these common diagnostic tools provide hemodynamic and anatomical vascular assessments, the potential for non-invasive physiological assessment of the lower extremities has more recently emerged through the use of magnetic resonance- and nuclear medicine-based approaches, which can provide insight into the functional consequences of PAD-related limb ischemia. This perspectives article specifically highlights and discusses the emerging applications of clinical nuclear medicine techniques for molecular imaging investigations in the setting of lower extremity PAD.

scholarly journals Pengaruh Terapi Psikoreligius Terhadap Penurunan Tingkat Depresi Pada Lansia

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Suryanti Suryanti ◽  
Dwi Ariani S
Keyword(s):  
Lower Extremity ◽  
Ulcer Healing ◽  
Healing Process ◽  
Lower Extremities ◽  
Control Group ◽  
Chi Square ◽  
Control Group Design ◽  
Diabetic Ulcer ◽  
Chi Square Test ◽  
Chi Square Analysis

Abstract: Lower Extremity Elevation, Diabetic Ulcer Healing Process. People with Diabetes Mellitus have poor circulation, especially in areas far from heart, these causing the length of time of wounds healing. One of the interventions to improve the peripheral tissue perfusion of patients with Diabetic Ulcer is lower extremity elevation. The purpose of this research is to describe the characteristics of respondents, knowing Diabetic Ulcer healing process without lower extremity elevation, knowing Diabetic Ulcer healing process with lower extremity elevation and knowing the effectiveness of Diabetic Ulcer healing without lower extremity elevation and with lower extremity elevation. This research is to design a queasy experiment non-equivalent control group design and analysis data used Chi-Square test. Results of this research are the elevation of lower extremities more effectively to increased Ulcers Diabetic healing process. It’s evidenced by the Chi-Square test using Pearson Chi-Square analysis and obtained ρ = 0,027 and α = 0,05. Elevation of lower extremities more effectively to increased Diabetic Ulcer healing in patients with Diabetic Ulcer in Melati I RSUD Dr. Moewardi. Lower extremity elevation expects can be applied in patients with Diabetic Ulcer.

scholarly journals Prevalence of asthma and other allergic diseases in pregnant women

2021 ◽  
Vol 38 (2) ◽  
pp. 125-134
Author(s):  
Nasrin Fazel ◽  
Asghar Kazemzadeh ◽  
Mojtaba Abdizadeh ◽  
Erika Jensem-Jarolim ◽  
Shohreh Shahrouyan ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Significant Relationship ◽  
Allergic Diseases ◽  
Clinical Problem ◽  
Antenatal Clinic ◽  
Chi Square ◽  
Increased Risk ◽  
Chi Square Test ◽  
Gina Guidelines ◽  
Asthmatic Group

Asthma and allergic disorders can affect the outcome of pregnancy. Asthma and allergies are common comorbidities during pregnancy and exacerbations are the major clinical problem. Results are not consistent between studies .Therefore, the aim of this study was to determine the frequency of asthma and allergic disease during pregnancy. This prospective cohort study was carried out at the antenatal clinic of Mobini Hospital in Iran. Overall, 1,603 women were enrolled prior to the 24th week of pregnancy. All participants were interviewed for allergy disease, allergic trigger factors and severity of asthma. Also, asthma control was categorized as per GINA guidelines. The diagnosis of asthma was based on symptoms, pulmonologist diagnosis, and spirometry assessment. The results were analyzed using SPSS version 20 and T-tests and Chi-square test. The prevalence of asthma during pregnancy was 2.1% among the participants. The most common allergens in asthmatic group were pollen, stress, and climate. There was a significant relationship between age, education and place of living in asthmatic and non-asthmatic group, p = 0.003, p=0.05, p=0.008, respectively. There was a significant relationship between asthma symptoms among the two groups (p=0.001). In addition, a significant relationship was found between asthma and other allergic diseases including eczema, allergy, rhinitis, and wheeze in asthmatic women, with a significant relationship between wheeze and coughing and allergy. Exposure of the pregnant women to high levels of allergens, like pollen, and allergic diseases resulted in an increased risk of pregnancy outcomes. Careful management of these diseases should prevent most of the serious complications

Gender-Based Analysis of Perioperative Outcomes Associated with Lower Extremity Bypass

2011 ◽  
Vol 77 (7) ◽  
pp. 844-849 ◽  
Author(s):  
Ashish K. Jain ◽  
Gabriela Velazquez-Ramirez ◽  
Philip P. Goodney ◽  
Matthew S. Edwards ◽  
Matthew A. Corriere
Keyword(s):  
Lower Extremity ◽  
Female Gender ◽  
Perioperative Outcomes ◽  
Chronic Obstructive ◽  
Complication Rates ◽  
Improvement Program ◽  
Chi Square ◽  
Increased Risk ◽  
Gender Based ◽  
Surgical Site Complications

We analyzed gender-based differences in preoperative factors, procedural characteristics, and 30-day outcomes after lower extremity bypass (LEB). LEB procedures were identified from the American College of Surgeons National Surgical Quality Improvement Program Participant User File. Groupwise comparisons of preoperative and procedural variables were made using chi square, t tests, and nonparametric methods; gender influences on mortality, systemic, and surgical site complications were evaluated using logistic regression. Women (4,107 of 11,011 [37.3%]) were older and had greater prevalence of hypertension, diabetes, chronic obstructive pulmonary disease, rest pain, dialysis, previous stroke, open/infected wound, and dependent functional status ( P < 0.01 for all comparisons). Women more commonly underwent emergent and extra-anatomic procedures but had lower rates of venous conduit or tibial level outflow use. Univariable associations between female gender and risk of 30-day mortality, systemic, and surgical site complications were identified; only the association with surgical site complications remained significant in multivariable modeling (OR, 1.8; 95% CI, 1.6 to 2.1; P < 0.0001). Gender-based differences in demographic, comorbidity, and procedural factors may contribute to disparities in perioperative outcomes associated with LEB. Female gender may be associated with increased risk for surgical site complications, but 30-day mortality and systemic complication rates in women may reflect effects of confounding factors rather than gender-specific influence.

The effect of footplate neuromuscular electrical stimulation on venous and arterial haemodynamics

2014 ◽  
Vol 30 (9) ◽  
pp. 648-650 ◽  
Author(s):  
Lavanya Varatharajan ◽  
Katherine Williams ◽  
Hayley Moore ◽  
Alun Huw Davies
Keyword(s):  
Blood Flow ◽  
Electrical Stimulation ◽  
Femoral Vein ◽  
Neuromuscular Electrical Stimulation ◽  
Duplex Ultrasound ◽  
Venous Stasis ◽  
Rank Test ◽  
Mean Velocity ◽  
Superficial Femoral Vein ◽  
Significant Difference

Objective This pilot study aims to determine the effect of the Revitive™ footplate neuromuscular electrical stimulation device on venous and arterial haemodynamic changes in healthy individuals. Method The blood flow (cc/min) and time averaged mean velocity (cm/s) of the superficial femoral vein and artery were measured using ultrasound at baseline, 15 min during, and immediately after cessation of the 30 min stimulation cycle. Data were analysed using the Wilcoxon matched-pairs signed rank test. Results Venous and arterial duplex ultrasound haemodynamic measurements were taken in 10 and 20 healthy volunteers, respectively. Mean age 38.7 (range 21–64), ankle brachial pressure index 0.9–1.0. At 15 min, there was a significant increase in venous median blood flow (88.3 cc/min, p = 0.014) and an increase in time averaged mean velocity (1.13 cm/s, p = 0.065) compared to baseline. Similarly, there was a significant increase in arterial median blood flow (38.7 cc/min, p < 0.0001) and time averaged mean velocity (2.21 cm/s, p = 0.0003) at 15 min compared to baseline. There was no significant difference in venous or arterial measurements compared to baseline after stimulation cessation. Conclusions Blood flow and time averaged mean velocity increased during neuromuscular electrical stimulation but returned to baseline once stimulation had stopped. By improving blood flow, neuromuscular electrical stimulation has the ability to enhance venous return, counteract venous stasis and improve limb arterial inflow.

scholarly journals The Use of Doppler Ultrasound to Diagnose Deep Vein Thrombosis of the Lower Limbs

2021 ◽  
Vol 8 (4) ◽  
pp. 7-13
Author(s):  
Nagla Hussein ◽  
Mohamed Khalid
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Femoral Vein ◽  
Lower Extremities ◽  
Duplex Ultrasound ◽  
Imaging Method ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Age Range ◽  
Deep Vein

In most cases of pulmonary embolism, death occurs as a result of deep vein thrombosis (DVT) of the lower extremities. Therefore, to avoid DVT complications and sequel, DVT must be diagnosed as early as possible and this can be achieved via B-mode and colour Doppler imaging. The present paper seeks to investigate the suitability of the imaging method of ultrasound for lower extremity DVT diagnosis and to explore the outcomes of the use of this method in DVT cases. To this end, the paper undertakes a retrospective descriptive study of 50 cases of ultrasound-based diagnosis of DVT at King Khalid Hospital in the period between January 2019 and August 2020. Half of the cases were subjected to compression, colour, and duplex ultrasound, 14 cases were subjected to compression and duplex ultrasound, and 11 cases were subjected to compression and colour Doppler. The mean age across all cases was 46.2±19.9 years. The majority of cases (56%) were in the age range 22-41 years old (n=28), while 28% of cases were in the age range 42-61 years old (n=14), 6% of cases were in the age range 62-81 years old (n=3), and 10% of cases were in the age range 82-102 years old (n=5). Regarding sex, females accounted for 60% of cases, while males accounted for the rest of 40%. Furthermore, in 90% of cases (n=45), just one lower extremity was affected, whereas in 10% of cases (n=5), both lower extremities were affected. Regarding thrombus location, it was found mostly in the area above the knee, particularly the popliteal vein (34%), common femoral vein (18%), and superficial femoral vein (20%). Moreover, 2% of cases presented thrombus in the calf vein. In 26% of cases, multiple veins were affected. DVT was acute in 76% of cases (n=38) and chronic in 24% of cases (n=12). It is concluded that symptomatic and at-risk cases benefit from the use of ultrasound for DVT diagnosis. The suitability of this method stems from its lack of invasiveness and capability to assess thrombus location, magnitude, and stage.

Abstract WP287: Screening Venous Ultrasound For Asymptomatic Lower Extremities Deep Venous Thrombosis In Acute Stroke Patients: Will It Change Management Strategies?

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Linda P Ha ◽  
Maria Galang
Keyword(s):  
Lower Extremity ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Acute Stroke ◽  
Management Strategies ◽  
Lower Extremities ◽  
Duplex Ultrasound ◽  
Trauma Patients ◽  
Stroke Patients ◽  
Anticoagulation Management

INTRODUCTION: Deep venous thromboses in stroke patients are often asymptomatic. There is limited support that screening for asymptomatic lower extremities DVT with venous duplex ultrasound changes clinicians’ management of stroke patients. Hypothesis: We hypothesized that the detection of asymptomatic deep venous thrombosis in acute stroke patients would result in changes or intensification of anticoagulation management strategies. Methods: We performed a retrospective chart review of all strokes (ischemic and hemorrhagic), orthopedic surgery, and trauma patients admitted to our Acute Rehabilitation Unit (ARU) between January 2004 and December 2009. We selected out all stroke patients and recorded those as asymptomatic DVT if there was no documentation of signs or symptoms for DVT by the primary provider within 48 hours prior to obtaining a lower extremity venous ultrasound. A change in anticoagulation management was noted if any addition or change to the patient’s admitting anticoagulation intervention. Results: There were 909 patients admitted to our ARU. Of those patients, 78 patients were diagnosed with an asymptomatic lower extremity DVT prior to transfer to the ARU. Strokes patients accounted for 34 (43.5%) of these 78 patients. All of the stroke patients were under the care of a neurology team. A majority of the lower extremity DVT among the stroke patients were considered acute (N=30;88.2%) and 21% (N=7) had bilateral, acute DVT. Most of the stroke patients received DVT prophylaxis on admission (N=26;76.4%). After diagnosis of an acute DVT, clinicians changed their management strategies in 65% of cases, whereas in 23.5% of cases there were no changes. Among the changes in management, 50% of patients (11/22;50%) were started or had an escalation in anticoagulation treatment. Interrupted venal cava filter was placed in 5 patients and serial venous ultrasound surveillance was used for 7 patients. Conclusions: This study shows that the detection of an acute asymptomatic lower extremity DVT in stroke patients resulted in anticoagulation management strategies changes for most stroke patients. It also supports the need to perform screening venous ultrasound on all acute stroke patients.

scholarly journals Evaluation of Experience with Lower Extremity Arterial Injuries at an Urban Trauma Center

2018 ◽  
Vol 27 (01) ◽  
pp. 029-034 ◽  
Author(s):  
Randall Franz ◽  
Joshua Hill ◽  
Michael Lieber ◽  
John Galante ◽  
Christopher Tanga
Keyword(s):  
Lower Extremity ◽  
Trauma Center ◽  
Injury Severity ◽  
Surgical Techniques ◽  
Blunt Injury ◽  
Chi Square ◽  
Lower Extremity Injuries ◽  
Arterial Injuries ◽  
Increased Risk ◽  
Extremity Injuries

AbstractLower extremity arterial injuries (LEAIs) can be complicated injuries resulting in limb loss and death. Patients with LEAI often have multiple injuries increasing the risk for morbidity and mortality. We sought to evaluate the incidence and management of LEAI and to define associations between injuries and outcomes. We performed a retrospective review of LEAI at an urban level-1 trauma center from April 2005 to April 2015. Chi-square tests were used to compare independent groups with respect to mortality and amputation. Means were compared between independent groups using two-sample t-tests. From April 2005 to April 2015, 208 arterial injuries occurred in 163 patients. The majority (80.4%) suffered concomitant lower extremity injuries with 35.6% suffering systemic injuries. Surgical intervention was required for 72.1% of injuries. Amputation rate was 14.7%. Mortality rate was 8.0%. Data from 2010 to 2015 were more specifically analyzed. Injury severity score (ISS) was higher with fatalities (37 ± 13.16 vs. 11.8 ± 8.51, p < 0.0001) and in patients requiring an amputation (25.4 ± 15.32 compared with 11.6 ± 9.05, p = 0.0015). Popliteal artery injury was most likely to require an amputation (odds ratio [OR] = 2.9, p = 0.04). Mortality was more likely when systemic injuries were present (OR = 18.1, p = 0.0005). The majority of patients with arterial injuries require surgical management, most often with open surgical techniques. Arterial injuries associated with systemic injuries, blunt injury mechanisms, and higher ISS are at a significantly increased risk of mortality.

scholarly journals Impact of Knee Scooter Flexion Position on Venous Flow Rate

2018 ◽  
Vol 40 (1) ◽  
pp. 80-84 ◽  
Author(s):  
David J. Ciufo ◽  
Michael R. Anderson ◽  
Judith F. Baumhauer
Keyword(s):  
Flow Rate ◽  
Thrombus Formation ◽  
Volumetric Flow Rate ◽  
Vessel Diameter ◽  
Left Knee ◽  
Venous Stasis ◽  
Level Of Evidence ◽  
Mean Velocity ◽  
Venous Flow ◽  
Mobility Device

Background: The knee scooter is a commonly used mobility device in the setting of unilateral below-knee immobilization. The bent-knee posture has been shown to decrease venous flow in a seated position, but the knee scooter differs as the patient is weightbearing through the affected extremity. Our goal was to investigate the effects of knee scooter positioning on popliteal venous flow. Methods: Duplex ultrasonography was performed to obtain venous diameter and flow velocity of the popliteal vein on healthy subjects over the age of 18 without immobilization. Measurements were performed on the left knee of each subject while standing and with the same knee flexed on the knee scooter, by 2 physicians trained in ultrasound techniques. Mean velocity, peak velocity, vessel diameter, and volumetric flow rate were calculated and t tests were performed for each variable. A power analysis was performed, determining that 9 subjects would provide 80% power with an alpha of 0.05. A total of 13 subjects participated in the study. Mean age was 33 (range 20-56) years, with 6 females and 7 males. Results: Measurements of subjects while standing and on the knee scooter demonstrated a significant decrease in mean velocity (6.5 vs 3.2 cm/s, P < .01) and volumetric flow rate (227.8 vs 106.2 mL/min, P < .01) while subjects were using the scooter. Vessel diameter (0.82 vs 0.78 cm, P = .15) and peak velocities (19.8 vs 14.7 cm/s, P = .19) were not significantly different between standing and kneeling positions. Conclusion: Our findings demonstrated a statistically significant decrease in volumetric flow rate in subjects using a knee scooter device with a flexed knee. Although venous stasis is a known risk factor for DVT, flow rate thresholds for increased thrombus formation are not well defined. The duration of scooter use, or flexed knee positioning, may have some effect on the degree of stasis. This finding should caution orthopedists to consider the risk attributed to the knee scooter as part of their overall patient assessment. Level of Evidence: Level II, therapeutic, comparative study.

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