scholarly journals Interrelation of venous and osteoarticular pathology in patients with Giacomini's vein

Author(s):  
G. V. Yarovenko ◽  
A. I. Zhdanova

Objective: To establish a possible relationship between the Giacomini vein and osteoarticular pathology of the lower extremities in chronic venous diseases (CVD).Materials and methods. In 115 examined patients (out of 321), we identified the Giacomini vein (92 women, 23 men). The average age of men was 44.82 ± 1.62 years; women – 45.36 ± 3.31 years. All patients were divided into 3 groups by anatomical randomization. The first group was without pathology, the second group of patients had only CVD, and the third group included patients with CVD and osteoarticular pathology. The criteria for inclusion in the groups were: the presence of Giacomini vein in patients, chronic venous disease and osteoarticular pathology on one or both lower extremities. Exclusion criteria: age of patients less than 18 years, the presence of CVD C5-C6 according to the CEAP classification, post-traumatic changes in the osteoarticular system, post-thrombotic transformation of the veins of the lower extremities. Using triplex angioscanning, the anatomical features of the structure of the venous system of the lower extremities were assessed. The study of the condition of the foot was carried out using the Friedland method.Results. Group I with an absolute norm of the venous and osteoarticular systems included 30 people (26 %). The second group consisted of 45 patients (39.22 %) with CVD C0-C4 according to CEAP, and the third group consisted of 40 patients (34.78 %) who, in addition to venous, osteoarticular pathology. Chronic venous diseases in patients of groups II and III were distributed as follows: C0 – 25.6 %; C1 – 16.4 %; C2 – 49.4 %; C3 – 4.3 %; C4 – 4.3 % on the CEAP scale. Among the osteoarticular pathology, the most numerous group consisted of changes in the configuration of the foot, non-traumatic deformities – 32 (27.81 %) cases. To confirm the relationship between venous and osteoarticular pathology, we used the Pearson criterion. We found a significant correlation in the presence of nontraumatic deformities of the foot in the group of patients with CVD (Pearson's criterion 0.749642; p < 0.22). A strong correlation was established between the age of patients and changes in the venous and osteoarticular systems of the lower extremities (Pearson's criterion 0.7677696; p < 0.22), which confirms the relationship between the development of nontraumatic changes in the foot and CVD in patients with Giacomini vein with age.Conclusion. It was found that the presence of an altered Giacomini vein leads to an aggravation of venous stasis in the lower extremities, which in turn increases the likelihood of developing venous pathology. Chronic diseases of the veins of the lower extremities contribute to dystrophic changes in soft tissues, most pronounced in the distal part of the extremity and, as a consequence, predispose to the development of osteoarticular pathology. 

2018 ◽  
Vol 11 (3) ◽  
pp. 183-185
Author(s):  
Galina Viktorovna Yarovenko ◽  
Alexey Vitalievich Fesun

According to modern data, there are no signs of chronic venous disease in only 15.9% of people. Observing the clinical data of recent years, there is a tendency to increase the number of people with venous diseases and, unfortunately, the number of young patients is increasing (there are data that schoolchildren of the senior classes have signs of varicose transformation in 10-15%). Polymorphism of matrix metalloproteinase-12 is a key link in the pathogenesis of varicose veins.We conducted surveys of 50 patients. The average age is 43.7 ± 15.9 years, of them women 32, men 18 people. All patients with the class C2-C6 varicose veins (CEAP-classifier) ​​were divided into two groups by the method of serial sampling: group I (n = 20) - with relapse of varicose veins; Group II (n = 30) - patients treated with varicose disease for the first time. The only exception was patients with deferred vein thrombosis. Ultrasound diagnosis of the main veins of the lower extremities and genomic analysis of blood samples of patients was used.The obtained results confirm that in patients of the I group the MMP-12 gene occurs in 80% of cases (homo- and heterozygous variation), whereas in group II only in 33.3% of cases. The Pearson consensus criterion is 10.4 (the critical value of the criterion is 6.63). The significance level of this relationship corresponds to p <0.01. The statistical significance of the frequency of recurrence of varicose disease and the MMP-12 gene was established using the Spearman rank correlation coefficient, which is equal to 1,000 (criterion value is 0.398). Dependence of signs is statistically significant, with p <0.05


Author(s):  
Armand Cholewka ◽  
Karolina Sieroń-Stołtny ◽  
Joanna Kajewska ◽  
Agnieszka Cholewka ◽  
Zofia Drzazga ◽  
...  

The aim of the study was to determine the diagnostic usefulness of thermal imaging as tool to find quantitative parameters in lower-limb primary chronic venous diseases and insufficiency of superficial veins. There were significant differences obtained in thermal maps of lower extremities between patients and healthy. The correlations were obtained between temperature parameters counted from thermal imaging and duplex scanning. Such results also suggest that thermovision diagnostics may be useful as a complementary and first of all objective method that can be used in the diagnosis of chronic venous diseases in the lower extremities. It may suggest that thermovision may be used as a screening method or together with an ultrasound diagnosis in different superficial veins disorders.


2021 ◽  
pp. 026835552110553
Author(s):  
Sergio Q Belczak ◽  
Rubiana Neves Ramos ◽  
Jose Maria Pereira de Godoy

Aim The aim of the present study was to show that an increase in weight leads to the aggravation of limited joint mobility. Method One hundred sixteen patients with varicose veins of the lower limbs and body mass index (BMI) higher than 30 kg/m2 were evaluated at the Belczak Clinic in Maringá, Brazil. All patients were evaluated by the same physician, and the goniometric readings were performed on all patients by a physiotherapist. The participants were then divided into three groups based on BMI: Group I—BMI between 30 and 40. Group II—BMI between 40 and 50, and Group III—BMI > 50. Results There is a significant difference between the groups detected. Conclusion The present findings show that an increased BMI in obese individuals with chronic venous disease is associated with a progressive limitation of ankle mobility.


2013 ◽  
Vol 29 (10) ◽  
pp. 648-653 ◽  
Author(s):  
Mong-Loon Kuet ◽  
Tristan RA Lane ◽  
Muzaffar A Anwar ◽  
Alun H Davies

Objectives This work was presented as a poster in the American Venous Forum 25th Annual Meeting; 28 February 2013; Phoenix, Arizona, USA. Quality of life (QoL) is an important outcome measure in the treatment for chronic venous disease. The Aberdeen Varicose Vein Questionnaire (AVVQ) and the ChronIc Venous Insufficiency quality of life Questionnaire (CIVIQ-14) are two validated disease-specific QoL questionnaires in current use. The aim of this study is to evaluate the relationship between the AVVQ and the CIVIQ-14 to enable better comparison between studies and to compare these disease-specific QoL tools with generic QoL and clinician-driven tools. Methods Adults attending our institution for management of their varicose veins completed the AVVQ, CIVIQ-14 and EuroQol-5D (EQ-5D). Clinical data, CEAP classification and the Venous Clinical Severity Score (VCSS) were collected. The relationship between the AVVQ and CIVIQ-14 scores was analysed using Spearman’s correlation. The AVVQ and CIVIQ-14 scores were also analysed with a generic QoL tool (EQ-5D) and a clinician-driven tool, the VCSS. Results One hundred patients, mean age 57.5 (44 males; 56 females), participated in the study. The median AVVQ score was 21.9 (range 0–74) and the median CIVIQ-14 score was 30 (range 0–89). A strong correlation was demonstrated between the AVVQ and CIVIQ-14 scores ( r = 0.8; p < 0.0001). Strong correlation was maintained for patients with C1-3 disease ( r = 0.7; p < 0.0001) and C4-6 disease ( r = 0.8; p < 0.0001). The VCSS correlated strongly with the AVVQ and CIVIQ-14 scores ( r = 0.7; p < 0.0001 and r = 0.7; p < 0.0001, respectively). Both the AVVQ and CIVIQ-14 scores correlated well with the EQ-5D score ( r = −0.5; p < 0.0001 and r = −0.7; p < 0.0001, respectively). Conclusions This study demonstrates that there is good correlation between two widely used varicose vein specific QoL tools (AVVQ and CIVIQ-14) across the whole spectrum of disease severity. Strong correlation exists between these disease-specific QoL tools and generic and clinician-driven tools. Our findings confirm valid comparisons between studies using either disease-specific QoL tool.


2011 ◽  
Vol 27 (1) ◽  
pp. 13-18 ◽  
Author(s):  
J-F Uhl ◽  
M Chahim ◽  
F-A Allaert

Objective To study the relationship between the static foot disorders (SFDs) and chronic venous disease (CVD). Material and methods A retrospective study of 824 feet in unselected 412 patients seen by one phlebologist using a standardized record form. A complete clinical, aetiological, anatomical and pathological elements (CEAP) classification was determined. Alleged venous symptoms were recorded using a 10-point visual analogue scale and scored using a customized questionnaire. A standardized measurement of the Djian-Annonier angle was used to quantify and identify the presence of any static disorder of the foot. Results There were 156 men (37.8%) and 256 women (62.2%) who were included in this study. A majority of patients (59.3%) had a CEAP classification of C3 or greater. Static disorders of the feet were found to be very common in the study population: 137 feet were hollow feet (16.6%) and 120 flat feet (14.5%). Thus, 31% of all of the feet had some form of SFD. A significant correlation was found between the incidence of SFD and body mass index ( P < 0.01), the presence of symptoms ( P<0.001) and prolonged standing during the day (>5 hours, P < 0.05). The severity of the CVD, represented by the CEAP clinical classes, was also found to be very significantly related to the SFD ( P < 0.001). This correlation was found to be independent of age. Conclusion Static disorders of the foot can be considered as an important risk factor that negatively affects CVD. In daily practice, it is often underestimated. This emphasizes the crucial importance of the detection of SFD during the clinical exam of all CVD patients. Correction of static disorders of the feet will improve symptoms due to the SFD, as well as those related to venous stasis. These results can easily be explained by improvement of foot pump efficacy during walking.


2018 ◽  
Vol 28 (1) ◽  
pp. 89 ◽  
Author(s):  
Rafael Cunha de Almeida ◽  
Paulo Roberto Zamfolini Zachêu ◽  
Mariana Terra Diniz ◽  
Maria Carolina Cozzi Pires de Oliveira Dias ◽  
Isabella Cherkezian Guiguer ◽  
...  

Introduction: The Assessment of Burden in Chronic Venous Disease questionnaire (ABC-V) is a valuable tool for assessing the impact that chronic venous disease (CVD) has on patients’ quality of life (QL). There was a need for a translated and adapted version suitable for use in the Brazilian population. CVD is becoming a public health issue as the incidence and prevalence are high. The ABC-V can be used to collect information on patients’ QL and thus the development of a Brazilian version that facilitates research into the CVD population. Objective: To provide translation and cultural validation of the Assessment of Burden in Chronic-Venous Disease (ABC-V) questionnaire for the Portuguese language. Methods: The ABC-V was translated into Portuguese by two bilingual translators working independently. The translators then created a consensus version, which was translated back into English by two native English speakers. Finally all the versions were analysed by a committee of with expertise in translation and the two cultures involved. The committee produced a draft Portuguese-language version which was tested in a pilot sample of between 30 and 40 people. The committee evaluated feedback from the pilot sample on the clarity and comprehensibility of the draft version.  Results: The draft version was completed by 31 patients at the Chronic Venous Diseases Department of Padre Anchieta’s Teaching Hospital. With the analysis of the questionnaires used in the pre-test, it is possible to observe that in English, unlike Portuguese, verbs are often used in the passive tense. It also emerged that there was a need to use more colloquial terms and expressions so that the question would be easier to understand, whilst preserving the meaning of the original items. Changing the tone of the questionnaire in this way should make it more suitable for use with people from a wide range of socioeconomic levels, especially those with lower social status and less education. Because the questions are qualitative rather than quantitative they are more open to interpretation and elicit more subjective responses. This creates an additional difficulty in adapting the questionnaire for the Brazilian cultural context. The data from pilot-testing of the draft version was used to develop a translated and culturally adapted version of the ABC-V using the procedure described by Beaton et al.  Conclusion: A translated and culturally adapted version of the ABC-V suitable for use in Brazil has been developed and can be used to evaluate changes in the QL of Brazilian patients with CVD.


2004 ◽  
Vol 92 (11) ◽  
pp. 1003-1011 ◽  
Author(s):  
Alison Knaggs ◽  
Peter Mason ◽  
Ken Macleod ◽  
Konstantinos Delis

SummaryOur hypothesis was that, due to its sympatholytic action, epidural anesthesia (EA) administered as part of anesthesia in abdominal surgery would generate a marked venous leg flow enhancement, thus aiding in the prevention of peroperative venous stasis. We studied, and comprehensively quantified the venous haemodynamic changes in the lower limb during and immediately after abdominal surgery performed under EA and general (GA) anesthesia combined, in comparison to GA alone. This is a prospective, randomized, controlled study, stratified for hypertension and smoking, comprising ASA 1-2 patients undergoing elective total abdominal hysterectomy. Those with peripheral vascular or chronic venous disease, prior DVT or BMI>35 were excluded. Eligible recruits received either GA (Group GA) (n = 10; age 36-65, median 50) alone or epidural anesthesia (EA) and GA combined (Group EA/GA) (n = 9; age 32-58, median 46). EA (L1-2) was administered using lignocaine 2%. Both groups had GA induced with fentanyl and propofol, maintained with N2O and isoflurane; larygoscopy was facilitated with vecuronium; analgesia was provided either with morphine (Group GA) or epidurally with 2% lignocaine boli (Group EA/GA). Hemodynamics were determined at the popliteal vein in the horizontal supine position at baseline (resting prior to anesthesia), post epidural (20 min after delivery of EA), post induction (15 min after laryngeal intubation), surgery (upon uterus removal) and recovery (30 min after extubation). There was no difference in the mean velocity[Vmean] between the 2 groups at baseline (p = 0.35[Mann-Whitney]), and post induction (p = 0.5[Mann-Whitney]). However Vmean was significantly higher in Group EA/GA than Group GA, both at surgery (point estimate[PE]: 1.8 cm/s; 95% CI: 0.01, 6.3 cm/s; p <0.05[Mann-Whitney]) and recovery (PE: 2.6 cm/s; 95% CI: 0.4, 5.1 cm/s; p = 0.02[Mann-Whitney]). Volume flow[VQ] was similar in the 2 groups at baseline and post induction (both, p >0.1[Mann-Whitney]), but was significantly higher in Group EA/GA at surgery (PE: 54 ml/min; 95% CI: 18, 159 ml/min; p = 0.045[Mann-Whitney]) and recovery (PE: 49 ml/min; 95% CI: 16, 129 ml/min; p=0.0037[Mann-Whitney]). Peak velocity, Vmean and VQ increased significantly post epidural in Group EA/GA. Contrary to the venous leg flow attenuation in elective abdominal surgery under GA and upon its recovery, EA administered as part of GA is associated with a significant enhancement of both Vmean and VQ. This beneficial hemodynamic effect of EA at the vulnerable stage of recovery may be critically essential in light of enhanced blood viscosity, fibrinolytic shutdown, endothelial/platelet activation and immobility, acting in synergy with putative cardiorespiratory protection. The results of this study lend support to the preferential selection of combined EA/GA in subjects at high risk for venous thromboembolism, particularly when optimal DVT prophylaxis is practically unattainable due to limitations pertaining to the nature of surgery.


2019 ◽  
Vol 34 (7) ◽  
pp. 481-485
Author(s):  
Marco Antonio Ayala-García ◽  
Jorge Sanchéz Reyes ◽  
Norberto Muñoz Montes ◽  
Eduardo Guaní-Guerra

Objective To determine the frequency of use of elastic compression stockings in patients with lower extremity chronic venous disease. Methods An explorational, prospective, transversal, observational, descriptive, analytical study including 168 patients was performed. We identified the proportion of patients using elastic compression stockings. The odds ratio (OR) was used to determine the relation between elastic compression stocking use and previous medical attention for chronic venous disease. Results Only 59 patients (35.1%) were using elastic compression stockings at the time of the study. We determined that the patients who had received previous medical attention to manage chronic venous disease in their lower extremities were >3 times more likely to use elastic compression stockings than patients who had not received previous medical attention (OR = 3.3, p < 0.0001). Conclusions Although there is sufficient evidence of the effectiveness of elastic compression stockings for treating chronic venous disease in the lower extremities, their use is relatively infrequent (35.1%).


2008 ◽  
Vol 23 (3) ◽  
pp. 120-124 ◽  
Author(s):  
G Cavalheri ◽  
J M P de Godoy ◽  
C E Q Belczak

Objectives To correlate venous haemodynamic parameters of lower limbs and amplitude of ankle mobility with the clinical, aetiological, anatomical and pathological classification (CEAP) for venous disease. Methods Two hundred and eighty-four lower limbs of 142 Caucasian women were evaluated and distributed in six groups according to the CEAP classification: Group I = C0 and C1 ( n = 24); Group II = C2 ( n = 30); Group III = C3 ( n = 27); Group IV = C4 ( n = 23); Group V = C5 ( n = 20) and Group VI = C6 ( n = 18). Goniometric examinations of ankle joints and air plethysmography (APG) were performed. Analysis of variance and the Bonferroni correction, Kruskal-Wallis' non-parametric and Dunn tests were utilized for statistical analysis with the level of significance being set at 5% ( P value < 0.05). Results There were significant restrictions in ankle mobility seen by goniometry at the C5 stage. In addition, significant changes in the venous-filling index were identified at C2, changes in the ejection fraction at C4 and changes in the residual volume fraction at the C4 stage. Conclusion The evolution of the clinical state of ankles affected by venous diseases is correlated to a reduction of joint mobility and haemodynamic alterations identified using APG.


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