scholarly journals Raynaud fenomenas: ankstyvieji chirurginio gydymo rezultatai

2004 ◽  
Vol 2 (1) ◽  
pp. 0-0
Author(s):  
Giedrius Kviecinskas ◽  
Artūras Razbadauskas ◽  
Rimvydas Gutauskas
Keyword(s):  
Surgical Treatment ◽  
Raynaud’S Phenomenon ◽  
Middle Finger ◽  
Cold Test ◽  
Raynaud's Phenomenon ◽  
Minimal Invasive ◽  
Normal Range ◽  
Thoracic Sympathectomy ◽  
Early Results ◽  
Ganglion Stellatum

Giedrius Kviecinskas1, Artūras Razbadauskas2, Rimvydas Gutauskas21 Klaipėdos jūrininkų ligoninės Chirurgijos klinika,Liepojos pl. 45, LT-5809 KlaipėdaEl paštas: [email protected] Klaipėdos universitetas,H. Manto g. 84, LT-5800 KlaipėdaKlaipėdos jūrininkų ligoninės Chirurgijos klinika,Liepojos pl. 45, LT-5809 Klaipėda Įvadas / tikslas Teigiama, kad Raynaud fenomenas būdingas apie 22% pasaulio žmonių. Moterims jis pasitaiko penkis kartus dažniau nei vyrams. Darbo tikslas – išsiaiškinti Raynaud fenomeno chirurginio gydymo ankstyvuosius rezultatus. Metodas Darbo pobūdis retrospektyvus. Nagrinėtos 1997–2003 m. Klaipėdos jūrininkų ligoninėje nuo Raynaud sindromo gydytų ligonių, kuriems buvo atliktos krūtininės simpatektomijos, ligos istorijos ir ambulatorinės kortelės. Naudojant šalčio mėginį, lyginti priešoperaciniai duomenys ir ankstyvieji krūtinės simpatektomijos rezultatai. Šalčio mėginys – tai kraujo įsotinimo deguonimi matavimas didžiajame rankos piršte, palaikius plaštaką penkias minutes +2, +3 °C temperatūros tekančiame vandenyje. Nustatant operacijos indikacijas atsižvelgta į ligos trukmę, gretutines ligas. Ligoniai tirti ieškant galimo krūtinės atvaros sindromo, taip pat jiems atlikta žvaigždinio mazgo blokada. Rezultatai 1997–2003 metais Klaipėdos jūrininkų ligoninėje 22 ligoniams atliktos 23 torakalinės simpatektomijos operacijos. Visiems jiems prieš operaciją ir antrą pooperacinę parą atliktas šalčio mėginys, siekiant įvertinti operacijos veiksmingumą. Atliekant šalčio mėginį prieš operaciją, kraujo įsotinimas deguonimi buvo neišmatuojamas ir pasiekdavo normalią ribą (95–99% SaO2) po 30–36 minučių. Antrą pooperacinę parą kraujo įsotinimas deguonimi sunormalėdavo per 1–2 minutes. Išvados Tyrimai rodo, kad chirurgiškai gydant Raynaud fenomeną, gaunami geri rezultatai ankstyvuoju pooperaciniu laikotarpiu. Prasminiai žodžiai: Raynaud fenomenas, torakalinė simpatektomija, mažai invazyvi chirurgija, saturacija The Raynaud phenomenon: early results of surgical treatment Giedrius Kviecinskas1, Artūras Razbadauskas2, Rimvydas Gutauskas2 Background / Objective The Raynaud disease phenomenon is found in about 22% of the world's population. This syndrome affects women more frequently than men. The study reports on the effectivity of thoracic sympathectomy in 1997–2003. This effectivity was valuated by a new method – oxygen saturation repair after "cold test" in the middle finger of the operated on side. Methods This work is a retrospective survey of the investigation and treatment of patients with Raynaud syndrome. We established the indications of the surgical treatment of Raynaud's phenomenon. The "cold test" was employed to observe short-term results of this treatment. The "cold test" is the measurement of O2 saturation in the middle finger of the hand after keeping it for 5 minutes in water at (+2)–(+3) C. The "cold test" was used to test patients before operation and on the second postoperative day after thoracic sympathectomy. To determine the indications of surgical treatment, we considered the concomitant diseases and the duration of Raynaud's phenomenon. The patients were investigated for the possibility of thoracic outlet syndrome. Before surgery, for all patients the ganglion stellatum blockade was performed. Results During 1997–2003, 23 sympathectomies for 22 patients were performed. All patients were tested with the "cold method" before surgery and on the second postoperative day. Before operation, O2 saturation was unmeasurable and restored till the normal range after 30–36 minutes. On the second postoperative day the saturation was unmeasurable too, but it restored to the normal range in 1–2 minutes. Conclusions The surgical treatment of Raynaud's phenomenon is effective in a short postoperative period. The "cold method" is effective for evaluating effectivity of thoracic sympathectomy. Keywords: Raynaud's phenomenon, thoracic sympathectomy, minimal invasive surgery, saturation

scholarly journals Uniphasic Blanching of the Fingers, Abnormal Capillaroscopy in Nonsymptomatic Digits, and Autoantibodies: Expanding Options to Increase the Level of Suspicion of Connective Tissue Diseases beyond the Classification of Raynaud’s Phenomenon

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Francesca Ingegnoli ◽  
Roberta Gualtierotti ◽  
Annalisa Orenti ◽  
Tommaso Schioppo ◽  
Giovanni Marfia ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Early Diagnosis ◽  
Raynaud’S Phenomenon ◽  
Connective Tissue Diseases ◽  
Middle Finger ◽  
Raynaud's Phenomenon ◽  
Potential Development ◽  
Colour Changes

In patients with Raynaud’s phenomenon (RP), the role of medical history, capillaroscopy, and autoantibodies in order to provide an early diagnosis of connective tissue disease (CTD) were examined. 115 consecutive adults with uni-, bi-, or triphasic colour changes of the fingers were studied. RP was bilateral in 92.7% of patients. The middle finger was significantly more affected. A lack of association between fingers affected by RP and fingers with capillary abnormalities was observedOR=0.75(0.34–1.66). RP with the cyanotic phase had a higher risk at capillaroscopy to have hemorrhagesOR=4.46(1.50–13.30) and giant capillariesOR=24.85(1.48–417.44). The thumb and triphasic involvement have an OR of 1.477 and 1.845, respectively. RP secondary to systemic sclerosis (SSc) had greater value of VAS pain (p=0.011). The presence of anti-centromere antibodies was significantly associated with a higher risk of SSc (p<0.001). 44.3% of subjects had uniphasic blanching of the fingers, and among these, 27% was diagnosed as having an overt or suspected CTD. Markers of a potential development of CTDs include severe RP symptoms, positive autoantibodies, and capillary abnormalities. These data support the proposal to not discharge patients with uniphasic blanching of the fingers to avoid missing the opportunity of an early diagnosis.

A New Cold Test for the Diagnosis of Raynaud's Phenomenon

1987 ◽  
Vol 1 (4) ◽  
pp. 474-478
Author(s):  
Michel Vayssairat ◽  
Philippe Evenou ◽  
Nathalie Baudot ◽  
Pascal Priollet ◽  
Martine Gilard
Keyword(s):  
Raynaud’S Phenomenon ◽  
Cold Test ◽  
Raynaud's Phenomenon

Thermosemiotics of the hands. Report 2. Thermal patterns of the hands in patients with upper limbs vascular disorders, Raynaud’s phenomenon, after thoracic sympathectomy, in ischemic heart disease and a number of other diseases

2021 ◽  
pp. 62-70
Author(s):  
M. G. Volovik ◽  
I. M. Dolgov
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Ischemic Heart ◽  
Upper Limbs ◽  
Vascular Disorders ◽  
Surgical Interventions ◽  
Thoracic Sympathectomy ◽  
Screening Diagnostics

This review is devoted to the thermogaphic hands examination in patients with upper limbs vascular disorders (both arterial and venous), Raynaud’s phenomenon, ischemic heart disease and after surgical interventions on the vessels of the upper extremities, thoracic sympathectomy, as well as a number of more rare diseases and clinical situations. Studies of temperature distributions on the hands of such patients are promising in terms of creating, on their basis, decision support systems in screening, diagnostics and treatment monitoring.

A new cold test for the diagnosis of Raynaud’s phenomenon

1987 ◽  
Vol 1 (4) ◽  
pp. 474-478
Author(s):  
Michel Vayssairat ◽  
Philippe Evenou ◽  
Nathalie Baudot ◽  
Pascal Priollet ◽  
Martine Gilard
Keyword(s):  
Raynaud’S Phenomenon ◽  
Cold Test ◽  
Raynaud's Phenomenon

Ascorbic Acid does not Improve Endothelium-Dependent Flow-mediated Dilatation of the Brachial Artery in Patients with Raynaud’s Phenomenon Secondary to Systemic Sclerosis

2003 ◽  
Vol 73 (1) ◽  
pp. 3-7 ◽  
Author(s):  
M. E. Mavrikakis ◽  
J. P. Lekakis ◽  
M. Papamichael ◽  
K. S. Stamatelopoulos ◽  
Ch. C. Kostopoulos ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Smooth Muscle ◽  
Systemic Sclerosis ◽  
Endothelial Dysfunction ◽  
Brachial Artery ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Water Soluble ◽  
Placebo Administration ◽  
Flow Mediated Dilatation

Previous studies have shown that patients with Raynaud’s phenomenon secondary to systemic sclerosis present abnormal endothelial function; the mechanisms responsible for the endothelial dysfunction are unknown but increased vascular oxidative stress could be a possible cause. The hypothesis that a potent water-soluble antioxidant can reverse endothelial dysfunction in these patients was tested in the present study. We examined 11 female patients with Raynaud’s phenomenon secondary to systemic sclerosis and ten healthy control women by ultrasound imaging of the brachial artery to assess flow-mediated (endothelium-dependent) and nitrate-induced (endothelium-independent) vasodilatation. Flow-mediated dilatation and nitrate-induced dilatation were significantly reduced in patients with Raynaud’s phenomenon, indicating abnormal endothelial and smooth muscle cell function. Patients with Raynaud’s phenomenon entered a double-blind, randomized, crossover placebo-controlled trial and received orally 2 g of ascorbic acid or placebo; vascular studies were repeated two hours after ascorbic acid or placebo administration. Flow-mediated dilatation did not improve after ascorbic acid (1.6 ± 2.2% to 2.2 ± 2.5%, ns) or placebo administration (1.2 ± 1,9% to 1.7 ± 1.4%, ns); also nitrate-induced dilatation was similar after ascorbic acid or placebo (16 ± 7.4% vs 17 ± 8%, ns), suggesting no effect of ascorbic acid on endothelial and vascular smooth muscle function. In conclusion, ascorbic acid does not reverse endothelial vasomotor dysfunction in the brachial circulation of patients with Raynaud’s phenomenon secondary to systemic sclerosis. The use of different antioxidants or different dosing of ascorbic acid may be required to show a beneficial effect on endothelial vasodilator function.

The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud’s phenomenon secondary to collagenosis

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Drinda ◽  
Neumann ◽  
Pöhlmann ◽  
Vogelsang ◽  
Stein ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Plasma Viscosity ◽  
Laser Doppler ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Long Term Effects ◽  
Doppler Flowmetry

Background: Prostanoids are used in the treatment of Raynaud’s phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual. Patients and methods: The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud’s phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables). Results: Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud’s phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6. Conclusion: The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud’s phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.

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