Evaluation of the Microcirculatory Effects of Venoruton (H.R.) in Patients with Chronic Venous Hypertension by Laser-Doppler Flowmetry, Transcutaneous PO2 and PCO2 Measurements, Leg Volumetry and Ambulatory Venous Pressure Measurements

1989 ◽  
Vol 4 (1) ◽  
pp. 23-29 ◽  
Author(s):  
G. Belcaro ◽  
A. Rulo ◽  
C. Candiani
Keyword(s):  
Placebo Group ◽  
Marked Effect ◽  
Symptomatic Relief ◽  
Venous Pressure ◽  
Skin Irritation ◽  
Active Treatment Group ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Doppler Flowmetry ◽  
Scale Line

The effect of Venoruton on the symptoms and microcirculation was investigated in an open randomised placebo controlled study involving 35 patients with chronic venous hypertension. Treatment was for 6 weeks. There was a significant symptomatic relief (ache, cramps, skin irritation and swelling) according to an analogue scale line score in the active treatment group, but not in the placebo group. The symptomatic relief in this group was associated with a reduction in leg volume ( p < 0.5), resting and standing skin blood flow ( p < 0.05), restoration of the venoarteriolar reflex, a decrease in transcutaneous PO2 ( p < 0.01) an increase in PO2 ( p < 0.05). These parameters did not change in the placebo group. The results of this study demonstrate that Venoruton therapy has a marked effect on the microcirculation and indicate possible mechanisms of the relief of symptoms.

Changes in Microcirculation in Venous Ulcers with Essaven Gel

Angiology ◽  
2001 ◽  
Vol 52 (3_suppl) ◽  
pp. S23-S27 ◽  
Author(s):  
L. Incandela ◽  
G. Belcaro ◽  
M.R. Cesarone ◽  
M.T. De Sanctis ◽  
M. Griffin
Keyword(s):  
Placebo Group ◽  
Treatment Group ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Local Treatment ◽  
Venous Hypertension ◽  
Controlled Study ◽  
Single Application ◽  
Venous Ulcers

Microcirculatory changes in chronic venous insufficiency (CVI) due to venous hypertension produce venous hypertensive microangiopathy (VHM) and lead to ulceration. VHM is charac terized by enlarged, convoluted capillaries; increase in flux, permeability, and edema; and altered microlymphatics. PO2 is decreased and CO2 increased. Capillary exchanges are altered and nutritional alterations in association with microtrauma may cause venous ulcers. The aim of this pilot, cross-over, randomized, placebo-controlled study was to evaluate the effect of local treatment with Essaven gel (EG) (single acute application) in 10 subjects with VHM and venous ulcers. The study was structured over 3 days: day 1 was used for the control evalua tion for all patients. One group was randomized for the sequence placebo (day 2) and EG the following day; the second group with the sequence EG (day 2) and placebo (day 3). Indepen dently from the sequence, measurements of flux and PO2 in standard conditions showed positive changes (significant decrease of the abnormally increased flux, PO2 increase) in the EG treatment group. Changes in the placebo group were limited and associated with skin manip ulation. In conclusion, EG acutely improves microcirculation in limbs with VHM and ulceration even with a single application.

Microvascular Evaluation by Laser—Dopper Flowmetry of the Effects of Centellase in the Treatment of Severe Venous Hypertension and Leg Ulcers

1987 ◽  
Vol 2 (3) ◽  
pp. 189-195 ◽  
Author(s):  
G. Belcaro
Keyword(s):  
Venous Pressure ◽  
Venous Hypertension ◽  
Leg Ulcers ◽  
Vasomotor Response ◽  
Venous Ulceration ◽  
Doppler Flowmetry ◽  
Before And After ◽  
Venoactive Drugs ◽  
Positive Effect ◽  
Standard Techniques

A study of the microcirculation in patients with venous hyperterision and perimalleolar ulcers was used to evaluate the effects of medical treatment by Centellase 60. The evaluation of the resting flow and the observation of the venous response before and after treatment shows an interesting, positive effect of Centellase 60 in 25 patients with venous ulceration treated for 4 weeks. The decrease of the resting flow and the increased efficacy of the venous vasomotor response was both significant and associated with a significant decrease of the ulcerated areas. Laser-Doppler flowmetry was useful to demonstrate microcirculatory changes which were not revealed by standard techniques such as ambulatory venous pressure. It may be useful to reveal variations in venous hypertension produced by other treatments such as elastic compression or ‘venoactive’ drugs.

scholarly journals A Randomized Controlled Study to Observe the Efficacy of External Treatment With a Traditional Chinese Medicine Herbal Ointment on Malignant Plural Effusion: Outcome Report and Design Review

2016 ◽  
Vol 16 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Wu Feize ◽  
Liu Meng ◽  
Lou Yanni ◽  
Li Yuan ◽  
Jia Liqun ◽  
...  
Keyword(s):  
Placebo Group ◽  
Chinese Medicine ◽  
Treatment Group ◽  
Pleural Effusion ◽  
Traditional Chinese Medicine ◽  
Statistical Significance ◽  
Skin Irritation ◽  
Controlled Study ◽  
Symptom Scale ◽  
To Receive

Background. Malignant pleural effusion (MPE) is a common complication in most malignancies. Despite its frequent occurrence, current knowledge of MPE remains limited and the effect of the management is still unsatisfying. Traditional Chinese medicine (TCM) external treatment has unique advantages, such as quicker efficacy and fewer side effects. Objective. To observe the effects and safety of Kang’ai Xiaoshui ointment (TCM herbal ointment) in MPE. Design. This was a placebo-controlled double-blinded randomized study. A total of 80 patients were enrolled, of which 72 were randomized to receive Kang’ai Xiaoshui ointment or placebo at an allocation ratio of 1:1. Kang’ai Xiaoshui ointment or placebo was applied on the thorax wall for 8 hours daily. The intervention lasted 2 weeks. Kang’ai Xiaoshui ointment consisted of Astragalus membranaces （黄芪）, Semen pharbitidis （牵牛子）, Cassia twig （桂枝）, Pericarpium arecae （大腹皮）, Curcuma zedoary （莪术）, Borneol （冰片), and other substances. In both groups, diuresis and drainages were used as needed. Outcomes covered the quantity of pleural effusion evaluation, TCM Symptom Scale, Karnofsky Performance Scale, and safety indicators such as routine blood test, blood biochemistry test, and response table of skin irritation. Results. Of 72 patients randomized to receive Kang’ai Xiaoshui ointment or placebo along with symptomatic treatment, the response rate was documented as 42.4% for the treatment group and 25.0% for the placebo group ( P = .138). As for the TCM symptom scale, the treatment group showed improvement in chest distress ( P = .003), fullness and distention ( P = .042), shortness of breath ( P < .001), no statistical significance in palpitation ( P = .237), and pain ( P = .063), whereas the placebo group did not show statistical significance in any of the 5 symptoms. Major adverse events related to the treatment, mainly skin irritation, were distributed equally. Conclusions. Kang’ai Xiaoshui ointment showed a potential of reducing MPE, and it could alleviate symptoms of dyspnea. Thus, it may be appropriate as a supplementary intervention for MPE. There were some flaws in the study design. A larger scale and better designed trial is advocated.

Tissue Plasminogen Activator Release in Chronic Venous Hypertension due to Heart Failure

1992 ◽  
Vol 68 (03) ◽  
pp. 321-324 ◽  
Author(s):  
Irena Keber ◽  
Dušan Keber ◽  
Mojca Stegnar ◽  
Nina Vene
Keyword(s):  
Heart Failure ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Fibrinolytic Activity ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Plasminogen Activator Inhibitor 1 ◽  
Control Subjects ◽  
Tissue Plasminogen ◽  
Pai 1

SummaryIn order to study the effects of chronic venous hypertension due to heart failure on blood fibrinolytic activity, tissue plasminogen activator (t-PA) antigen, plasminogen activator inhibitor 1 (PAI-1) antigen, t-PA activity and PAI activity were measured before and after venous occlusion of the arm for 20 min in 15 patients with right-sided heart failure, 15 patients with left-sided heart failure, and 30 control healthy subjects. Central venous pressure, measured by observing the jugular veins, was above 15 cm of the blood column in all patients with right-sided heart failure, and normal (below 8 cm) in all patients with left-sided heart failure and control subjects. There was no difference in the basal concentrations of t-PA (11.0, 10.2 and 10.8 ng/ml; all values medians) and PAI-1 antigens and their activities between right and left-sided heart failure and the control subjects. After the occlusion, t-PA antigen increased significantly less in right-sided heart failure (28.6 ng/ml) than in left-sided heart failure and the control subjects (54.5 and 45.9 ng/ml, respectively). It was concluded that the poor increase in fibrinolytic activity that had already been reported in patients with heart failure, was due to low t-PA release during occlusion and not to a high basal PAI level. It was limited to the patients with right-sided heart failure and was probably the consequence of chronic systemic venous hypertension.

Effects of Consumption of Probiotic Powder Containing Lactobacillus Plantarum Dad-13 on Fecal Bacterial Population in School-Age Children in Indonesia

2019 ◽  
Vol 14 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Banin Maghfirotin Marta ◽  
Utami Tyas ◽  
Cahyanto Muhammad Nur ◽  
Widada Jaka ◽  
Rahayu Endang Sutriswati
Keyword(s):  
Placebo Group ◽  
Gut Microbiota ◽  
Lactobacillus Plantarum ◽  
Coliform Bacteria ◽  
School Age Children ◽  
Controlled Study ◽  
School Age ◽  
Double Blind ◽  
Probiotic Group ◽  
E Coli

Consumption of probiotics is known to influence the gut microbiota. The aim of this study was to assess the effect of probiotic powder containing Lactobacillus plantarum Dad-13 on bacterial composition in the gut by examining fecal samples of school-age children in Yogyakarta, Indonesia. This is a randomized, double-blind, placebo-controlled study. A total of 40 healthy subjects were recruited for this study and were divided into two groups: placebo group and probiotic group. The placebo group consumed skim milk and the probiotic group consumed probiotic powder containing L. plantarum Dad-13 (2 × 109 CFU/g) for 65 days. The results showed that placebo intake had no significant effect on gut microbiota; however, probiotic caused a significant increase in L. plantarum and Lactobacillus population, while decreasing the population of E. coli and non-E. coli coliform bacteria by 55% and 75%, respectively and Bifidobacteria count did not change significantly. The study concluded that consumption of probiotic powder L. plantarum Dad-13 could increase propionic acid thereby decreasing the gut pH which has an effect on the microbial population.

Effects of Intermittent Sequential Compression in Venous Hypertensive Microangiopathy

1994 ◽  
Vol 9 (3) ◽  
pp. 99-103 ◽  
Author(s):  
G. V. Belcaro ◽  
A. N. Nicolaides
Keyword(s):  
Venous Insufficiency ◽  
Marked Change ◽  
Venous Hypertension ◽  
Horizontal Position ◽  
Acute Effects ◽  
Doppler Flowmetry ◽  
Vasomotor Activity ◽  
The Mean ◽  
Intermittent Sequential Compression ◽  
Normal Controls

Objective: To investigate the acute effects of sequential compression on the microcirculation in limbs with chronic venous hypertension causing venous microangiopathy. Design: One group of patients with venous hypertension and a group of normal, comparable subjects were treated with intermittent sequential pneumatic compression applied for 30 min. Skin blood flow was measured by laser Doppler flowmetry at the perimalleolar region at rest (horizontal position) and on standing. The measurements were repeated at 0, 30 and 60 min after cessation of the compression. As criteria of inclusion, only limbs with high perimalleolar skin flux and decreased venoarteriolar response were included. Setting: St Mary's Hospital, London (teaching hospital). Patients, participants: Sixteen limbs in 16 patients with chronic venous hypertension and 12 limbs of comparable healthy volunteers were studied. Results: At rest, in the normal controls, the mean (SD) flux was 0.56 (0.3) units; it decreased on average by 35% on standing (venoarteriolar response). There was normal vasomotor activity. In patients, the mean flux was 1.45 (0.8) ( p < 0.025) and the median venoarticular response only 7%. There was very limited vasomotor activity. Vasomotor activity started 10 min after the commencement of compression. At the end of the compression period there was a marked change towards normality. Resting flux was 0.90 (0.5) (significantly decreased) and the venoarteriolar response had increased to 23% ( p < 0.025) with an improvement in vasomotor activity. These changes persisted at 30 and 60 min. Conclusions: The findings offer an explanation of the effect of sequential compression on the healing of leg ulcers in chronic venous insufficiency.

scholarly journals Intravenous Carbetocin to decrease blood loss during open myomectomy: a randomized placebo-controlled study

2017 ◽  
Vol 7 (1) ◽  
pp. 27
Author(s):  
Hany F. Sallam ◽  
Nahla W. Shady
Keyword(s):  
Placebo Group ◽  
Blood Loss ◽  
Operative Time ◽  
Uterine Leiomyomas ◽  
Reproductive Age ◽  
Controlled Study ◽  
Benign Tumors ◽  
Operative Blood Loss ◽  
Abdominal Myomectomy ◽  
To Receive

Background: Uterine leiomyomas are benign tumors of the uterus, which represent the most common neoplasms in women of reproductive age, and have a lifetime incidence of approximately 70% in the general population. The objective of this study was to assess the effect of using a single pre-operative dose of IV 100 μg Carbetocin on intra-operative blood loss in abdominal myomectomy surgeries.Methods: In a randomized double-blind placebo-controlled trial, 86 women undergoing abdominal myomectomy for symptomatic uterine leiomyomas were randomly assigned to receive a single dose of pre-operative of IV 100 μg Carbetocin (n = 43) or placebo (n = 43) just before the operation. The primary outcome was intra-operative blood loss.Results: Intra-operative blood loss was significantly lower in those women randomized to receive IV Carbetocin versus the placebo group (714.19±186.27 ml versus 1033.49±140.9 ml), p = 0.0001 The incidence of blood transfusion was increased in placebo group (69.8%) compared with (18.6%) in Carbetocin group, (P = 0.0001). Also, there was a significant reduction in operative time in Carbetocin group (66.35%±10.18) compared with placebo group (95.95±9.16), (P = 0.0001).Conclusions: A single pre-operative dose of IV Carbetocin (100 μg) is a simple applicable method for reducing intra-operative blood loss and operative time in abdominal myomectomy.

Blood flow, volume, and transit time in the pulmonary microvasculature using laser-Doppler

1994 ◽  
Vol 76 (6) ◽  
pp. 2643-2650 ◽  
Author(s):  
T. S. Hakim ◽  
E. Gilbert ◽  
E. M. Camporesi
Keyword(s):  
Blood Flow ◽  
Blood Volume ◽  
Transit Time ◽  
Flow Rate ◽  
Venous Pressure ◽  
Laser Doppler ◽  
Flow Volume ◽  
Doppler Flowmetry ◽  
Blood Flow Volume ◽  
Wide Range

Capillary transit time is determined by the ratio of capillary volume to flow rate. Exercise-induced hypoxemia is thought to occur because of the short transit time of erythrocytes in capillaries. The effect of flow rate on capillary volume (recruitment vs. distension) is controversial. In a perfused left lower lobe preparation in canine lungs, we used laser-Doppler flowmetry (model ALF21R) to monitor changes in blood flow, volume, and transit time in the microvasculature near the subpleural surface. Changes in total flow, blood volume, and total transit time (tt) were also measured. The results showed that microvascular volume approached maximum when flow rate was at resting value (0.4 l/min) and pressure in the pulmonary artery was > 6 mmHg relative to the level of the capillaries. In contrast, the total blood volume increased gradually over a wide range of flow rates. When flow increased 4.2 times (from 155 to 650 ml/min), tt decreased from 7.32 to 3.53 s; meanwhile, microvascular flow increased from 6.0 to 12.7 units and microvascular transit time decreased from 3.14 to 1.81 units. The changes in microvascular volume and transit time were essentially independent of whether the venous pressure was higher or lower than alveolar pressure. At very high flow (6–10 times resting value), tt fell gradually to approximately 1 s. Direct monitoring of transit time with the laser-Doppler also revealed a gradual decline in microvascular transit time as flow rate increased from 2 to 10 times the normal flow. (ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Protein-Losing Enteropathy and Plastic Bronchitis After the Fontan Operation

2018 ◽  
Vol 38 (6) ◽  
pp. e5-e12 ◽  
Author(s):  
Christine Peyton
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Complex Disease ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Plastic Bronchitis ◽  
Protein Losing Enteropathy ◽  
Fontan Physiology

Protein-losing enteropathy and plastic bronchitis remain challenging to treat despite recent treatment advances. Protein-losing enteropathy and plastic bronchitis have been diagnosed in patients with cardiomyopathy, constrictive pericarditis, and congestive heart failure. This article focuses on patients with protein-losing enteropathy or plastic bronchitis following the Fontan procedure. Patients with single-ventricle physiology who have undergone the Fontan procedure are at risk for these conditions. Fontan physiology predisposes patients to chronically low cardiac output, increased central venous pressure, and congestive heart failure. These altered hemodynamics lead to increased mesenteric vascular resistance, resulting in venous hypertension and congestion in protein-losing enteropathy. Plastic bronchitis is a complex disease in which chronic high lymphatic pressures from Fontan physiology cause acellular bronchial casts to develop. These entities may also occur in patients with normal Fontan hemodynamics. This article also covers medical and surgical interventions for protein-losing enteropathy and plastic bronchitis. (Critical Care Nurse. 2018;38[6]:e5–e12)

scholarly journals Evaluation of changes in laser Doppler flowmetry indices in patients with a combined subtype of rosacea under the influence of a course of complex phototherapy

2021 ◽  
Vol 20 (2) ◽  
pp. 125-136
Author(s):  
Kirill A. Novikov ◽  
Olga B. Tamrazova ◽  
Yuliya I. Matushevskaya
Keyword(s):  
Laser Doppler Flowmetry ◽  
Practical Interest ◽  
Intense Pulsed Light ◽  
Laser Doppler ◽  
Controlled Study ◽  
Complex Method ◽  
Pulsed Light ◽  
Doppler Flowmetry ◽  
Group I ◽  
Combined Subtype

BACKGROUND: The development of new methods for the treatment of rosacea, as well as a combination of various methods of physiotherapy, is of scientific and practical interest. In this work, the assessment of changes in microcirculation indices under complex phototherapy has been carried out. AIMS: Тo assess changes in microcirculation indices in patients with a combination of rosacea subtypes according to laser Doppler flowmetry under a course of complex phototherapy. MATERIAL AND METHODS: In 20172020 a randomized controlled study of 130 patients with a combination of rosacea subtypes. All patients were divided into 4 groups. In each separate group, laser therapy and 1% metronidazole cream were used (group I); phototherapy and 1% metronidazole cream (group II); complex photolaser therapy and 1% metronidazole cream (group III); in the comparison group (group IV), patients show only 1% metronidazole cream. The treatment, the duration of which was 3 months, included 6 sessions with an interval of 2 weeks. The effectiveness of therapy was assessed according to the data of laser Doppler flowmetry, reflecting changes in the hemodynamics of the microvasculature in the affected skin areas. RESULTS: The developed complex method, including exposure to intense pulsed light (intense pulsed light, IPL) 5201100 nm in combination with submillisecond neodymium laser radiation 1064 nm (submilisecond Nd: YAG laser 1064 nm) and daily application of 1% metronidazole cream showed the most pronounced improvement in the state of microcirculation according to laser Doppler flowmetry in comparison with the rest groups. Against the background of the course of complex phototherapy for all patients with the combined subtype of rosacea, statistically significant changes were in the volume of blood flow, modulation coefficients, coefficient of variation. On the contrary, no statistically significant changes were found in the ranges corresponding to active regulatory factors endothelial, neurogenic, myogenic, and passive respiratory and cardiac, as well as in the T index. CONCLUSION: After the course of complex phototherapy in the group of patients with a combination of rosacea subtypes, there was a decrease in the severity of clinical manifestations of diseases, as well as an improvement in the main indicators of microcirculation according to laser Doppler flowmetry.

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