scholarly journals Breaking the Tie: How to Start Rehabilitation in Patients With Severe Limiting Intermittent Claudication

2021 ◽  
Author(s):  
Bassem Zarif ◽  
Akram Samir ◽  
Safwat Elnahrawi ◽  
Eman Gamal
Keyword(s):  
Intermittent Claudication ◽  
Cardiovascular Complications ◽  
Exercise Intolerance ◽  
Common Symptom ◽  
First Line ◽  
Physical Effort ◽  
Improve Exercise Tolerance ◽  
Increased Risk ◽  
Artery Disease

Intermittent claudication (IC) is the most common symptom of peripheral artery disease (PAD). IC affects the quality of life and results in marked exercise intolerance and limitation to daily activities with increased risk of cardiovascular complications. Exercise training is the first line of conservative management in PAD. However, patients with IC Patient cannot tolerate exercise because of leg discomfort induced by physical effort. This review will address alternative rehabilitation strategies to reduce exercise limitations and improve exercise tolerance in patients with IC.

Intermittent claudication - the meaning of pharmacological and non-pharmacological therapy in chronic treatment

2021 ◽  
Vol 14 (3) ◽  
pp. 240-243
Author(s):  
Marta Wolska ◽  
Pamela Czajka ◽  
Marek Postuła
Keyword(s):  
Intermittent Claudication ◽  
Conservative Therapy ◽  
Ankle Brachial Index ◽  
Cardiovascular Complications ◽  
Pharmacological Therapy ◽  
Arterial Blood Flow ◽  
Diagnostic Process ◽  
Arterial Blood ◽  
Artery Disease

Intermittent claudication is a typical sign of peripheral vascular disease, which results from limited arterial blood flow due to atherosclerosis, appears during exercises and is relieved after a short break. Intermittent claudication often presents as a pain in the calf muscle after walking a particular distance. Physical examination, detailed interview and ankle–brachial index are key elements of the diagnostic process, which allows for diagnosis of peripheral artery disease. The treatment is dependent on multiple factors, including the dynamics of the disease and coexisting diseases. The aim of the treatment of patients with intermittent claudication is reducing the risk of cardiovascular complications and improving the quality of life. The treatment is based on a conservative therapy, especially march training. The pharmacological treatment is limited to a few medications, which are rarely used. In the advanced stage of the disease the most appropriate option seems surgery.

The Role of Revascularisation in Patients Undergoing Non-cardiac Surgery

2010 ◽  
Vol 5 (1) ◽  
pp. 104
Author(s):  
Daniel S Menees ◽  
Eric R Bates ◽  
◽  
Keyword(s):  
Cardiac Surgery ◽  
Prediction Models ◽  
Cardiovascular Complications ◽  
Weight Of Evidence ◽  
Beta Blockade ◽  
Cardiac Morbidity ◽  
Increased Risk ◽  
Reduction Strategies ◽  
Artery Disease ◽  
Risk Reduction Strategies

Coronary artery disease (CAD) affects millions of US citizens. As the population ages, an increasing number of people with CAD are undergoing non-cardiac surgery and face significant peri-operative cardiac morbidity and mortality. Risk-prediction models can be used to help identify those patients at increased risk of peri-operative cardiovascular complications. Risk-reduction strategies utilising pharmacotherapy with beta blockade and statins have shown the most promise. Importantly, the benefit of prophylactic coronary revascularisation has not been demonstrated. The weight of evidence suggests reserving either percutaneous or surgical revascularisation in the pre-operative setting for those patients who would otherwise meet independent revascularisation criteria.

Translation and Validation of the Brazilian-Portuguese Short Version of Vascular Quality of Life Questionnaire in Peripheral Artery Disease Patients with Intermittent Claudication Symptoms

2018 ◽  
Vol 51 ◽  
pp. 48-54.e1 ◽  
Author(s):  
Marilia de Almeida Correia ◽  
Aluísio Andrade-Lima ◽  
Paulo Longano Mesquita de Oliveira ◽  
Rômulo Martins Domiciano ◽  
Wagner Jorge Ribeiro Domingues ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intermittent Claudication ◽  
Brazilian Portuguese ◽  
Short Version ◽  
Life Questionnaire ◽  
Peripheral Artery ◽  
Quality Of Life Questionnaire ◽  
Artery Disease ◽  
Translation And Validation

scholarly journals Cardiovascular Effects in Childhood Cancer Survivors Treated with Anthracyclines

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Vivian I. Franco ◽  
Jacqueline M. Henkel ◽  
Tracie L. Miller ◽  
Steven E. Lipshultz
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cardiovascular Effects ◽  
Childhood Cancer Survivors ◽  
Cardiovascular Complications ◽  
Anthracycline Cardiotoxicity ◽  
Treatment And Prevention ◽  
Artery Disease

Anthracyclines are commonly used to treat childhood leukemias and lymphomas, as well as other malignancies, leading to a growing population of long-term childhood cancer survivors. However, their use is limited by cardiotoxicity, increasing survivors' vulnerability to treatment-related complications that can markedly affect their quality of life. Survivors are more likely to suffer from heart failure, coronary artery disease, and cerebrovascular accidents compared to the general population. The specific mechanisms of anthracycline cardiotoxicity are complex and remain unclear. Hence, determining the factors that may increase susceptibility to cardiotoxicity is of great importance, as is monitoring patients during and after treatment. Additionally, treatment and prevention options, such as limiting cumulative dosage, liposomal anthracyclines, and dexrazoxane, continue to be explored. Here, we review the cardiovascular complications associated with the use of anthracyclines in treating malignancies in children and discuss methods for preventing, screening, and treating such complications in childhood cancer survivors.

scholarly journals Use of Artra and Artra MSM Forte in osteoarthritis of the large joints and lowback pain

2019 ◽  
pp. 96-100
Author(s):  
E. P. Sharapova ◽  
L. I. Alekseeva
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
International Organizations ◽  
Joint Pain ◽  
Common Symptom ◽  
First Line ◽  
Knee Oa ◽  
Concomitant Medications ◽  
Lowback Pain

Knee and hip joint pain is the first and most common symptom that forces a patient to visit the doctor. Osteoarthritis (OA) treatment is aimed «primarily» at managing symptoms of the disease, i.e. reducing pain, improving the functional state of the joints, and finally at improving the patients’ quality of life. The Russian and international organizations have developed numerous guidelines for the treatment of OA, which include non-pharmacological and pharmacological methods, among which symptomatic slow-acting drugs are of special interest. These drugs are currently recommended to prescribe as the first-line drugs to treat OA. Analgesics and NSAIDs that rarely cause adverse effects, especially in older people and in patients with co-morbidities, who receive concomitant medications, are the most commonly prescribed medications for pain relief. This creates a problem when the drugs affect one another’s exposure and can limit the prescription of a range of drugs, which determines an increase in interest in other drugs called sustained-release symptomatic drugs, which are widely recognized in arthrology.The article presents the results of studies of Artra and Artra MSM Forte in patients with hip and knee OA, which were conducted in Russia.

The role of general surgery in the palliative care of patients with cancer

2015 ◽  
Author(s):  
Brian Badgwell ◽  
Robert S. Krouse
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Symptom Control ◽  
Palliative Surgery ◽  
Common Symptom ◽  
Life Outcomes ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Patient Reported

Palliative surgery is defined as surgical intervention in patients with incurable malignancy for symptoms attributable to their cancer. A considerable percentage of consultations at major cancer centres are palliative in nature, resulting in 13-21% of all operations meeting the criteria for palliative surgery. Common symptom groups for evaluation include gastrointestinal obstruction, wound problems/infections, gastrointestinal bleeding, and obstructive jaundice. This chapter outlines the indications, treatment options, and outcomes for these diagnoses and a few less common indications for surgical consultation. Clinical trials are infrequent in this population and there is a paucity of prospective studies with quality of life outcomes measures. Most studies focus on morbidity and mortality as palliative surgery has long been recognized as having increased risk for complications, although recent studies suggest an improvement in this regard. The benefits of palliative surgery should focus on quality of life, symptom control, and symptom prevention. Future studies will be needed to determine the definitions of success and hopefully include patient-reported outcomes assessment.

scholarly journals Recommendations for a Combined Laparoscopic and Transanal Approach in Treating Deep Endometriosis of the Lower Rectum—The Rouen Technique

2021 ◽  
Vol 11 (5) ◽  
pp. 408
Author(s):  
Şerban Nastasia ◽  
Anca Angela Simionescu ◽  
Jean Jacques Tuech ◽  
Horace Roman
Keyword(s):  
Circular Stapler ◽  
First Line ◽  
Lower Rectum ◽  
Complete Excision ◽  
Deep Endometriosis ◽  
Invasive Approach ◽  
Transanal Approach ◽  
Plasma Energy ◽  
Increased Risk

The complete excision of low rectovaginal deep endometriosis is a demanding surgery associated with an increased risk of intra- and postoperative complications, which can impact the quality of life. Given the choices of optimal surgery procedures available, we would like to emphasize that a minimally invasive approach with plasma medicine and a transanal disc excision could significantly improve surgery for deep endometriosis, avoiding the lateral thermal damage of vascular and parasympathetic fibers of roots S2–S5 in the pelvic plexus. The management of low rectal deep endometriosis is distinct from other gastrointestinal-tract endometriosis nodules. Suggestions and explanations are presented for this minimal approach. These contribute to individualized medical care for deep endometriosis. In brief, a laparoscopic transanal disc excision (LTADE; Rouen technique) was performed through a laparoscopic deep rectal dissection, combined with plasma energy shaving, and followed by a transanal disc excision of the low and mid-rectal deep endometriotic nodules, with the use of a semi-circular stapler. LTADE is indicated as the first-line surgical treatment for low and mid-rectal deep endometriotic nodule excisions, because it can preserve rectal length and innervation. This technique requires a multidisciplinary team with surgical colorectal training.

scholarly journals Associations between the measures of physical function, risk of falls and the quality of life in haemodialysis patients: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Karsten Vanden Wyngaert ◽  
Amaryllis H. Van Craenenbroeck ◽  
Sunny Eloot ◽  
Patrick Calders ◽  
Bert Celie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Physical Function ◽  
Exercise Intolerance ◽  
Cross Sectional ◽  
Walking Test ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Quadriceps Force

Abstract Background Impaired physical function due to muscle weakness and exercise intolerance reduces the ability to perform activities of daily living in patients with end-stage kidney disease, and by consequence, Health-Related Quality of Life (HRQoL). Furthermore, the risk of falls is an aggregate of physical function and, therefore, could be associated with HRQoL as well. The present study examined the associations between objective and subjective measures of physical function, risk of falls and HRQoL in haemodialysis patients. Methods This cross-sectional multicentre study included patients on maintenance haemodialysis. Physical function (quadriceps force, handgrip force, Sit-to-Stand, and six-minute walking test), the risk of falls (Tinetti, FICSIT-4, and dialysis fall index) and HRQoL (PROMIS-29 and EQ-5D-3 L) were measured and analysed descriptively, by general linear models and logistic regression. Results Of the 113 haemodialysis patients (mean age 67.5 ± 16.1, 57.5% male) enrolled, a majority had impaired quadriceps force (86.7%) and six-minute walking test (92%), and an increased risk of falls (73.5%). Whereas muscle strength and exercise capacity were associated with global HRQoL (R2 = 0.32) and the risk of falls, the risk of falls itself was related to psycho-social domains (R2 = 0.11) such as depression and social participation, rather than to the physical domains of HRQoL. Objective measures of physical function were not associated with subjective fatigue, nor with subjective appreciation of health status. Conclusions More than muscle strength, lack of coordination and balance as witnessed by the risk of falls contribute to social isolation and HRQoL of haemodialysis patients. Mental fatigue was less common than expected, whereas, subjective and objective physical function were decreased.

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