scholarly journals Comparative assessment of the clinical efficacy of first-generation phlebotonics in the complex treatment of patients with chronic venous diseases of the lower limbs

Author(s):  
S. E. Katorkin ◽  
P. N. Myshentsev ◽  
O. E. Lisin ◽  
A. A. Rozanova

Target. Comparative assessment of the clinical efficacy of Aescusan I generation phlebotonics application in the complex treatment of patients with CVD.Material and methods. Analysis of treatment of 380 patients who applied for a phlebological appointment at the polyclinic department of SamSMU Clinics for the period from September 2017 to March 2019 was conducted. Group I (n = 104) included patients with even outpatient card numbers who were prescribed Troxevasin as a first-generation phlebotonic according to the scheme recommended by manufacturers Group II (n = 276) included patients with odd outpatient card numbers who were prescribed Aescusan (an extract of horse chestnut seeds Aesculus hippocastanum, active ingredient of which is aescin) as phlebotonics of the first generation according to the scheme recommended by the manufacturers. All patients were examined by a phlebologist before and after 1 course of treatment. Clinical efficacy of the therapy was assessed by the severity of the pain syndrome, feeling of heaviness, swelling and seizures using visual analogue scale (VAS). In addition, the effectiveness of conservative therapy was assessed through interviews and questionnaires. For a comparative assessment of the severity of edema syndrome, the lower limb circumference was measured at ankle level using a graduated tape.Results. No side effects were detected during clinical observation of the use of drugs. After the course of treatment, most of the observations showed positive dynamics. Changes in clinical symptoms (pain, seizures, heavy legs) in Group I were statistically unreliable (p>0.05). In the second group there was a decrease of pain syndrome intensity by 73,2%, a decrease of convulsions - by 63,5%, a decreaseof heaviness feeling – by 73,7%. In the course of the survey, 272 patients (98.5%) of Group II evaluated the treatment results as good, 4 patients (1.5%) did not notice any treatment results.In the course of repeated examination after the treatment 96,5% of doctors noted the result in Group II as good, 3,5% - as satisfactory. Conclusion. Thus, the results of complex treatment of patients with CVD showed that the use of 1st generation phlebotonics should be considered not only as pathogenetically justified, but also effective from the clinical point of view. Application of Aescusan drug leads to statistically significant reduction of clinical symptoms (subjective and objective) of lower limbs CVD. 

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Sezen Karabörklü Argut ◽  
Nilgün Türker ◽  
Derya Çelik ◽  
Önder İsmet Kılıçoğlu

Objective: The weakness of the quadriceps strength in patellofemoral pain syndrome (PFPS) is very evident. Therefore, quadriceps strengthening exercises are very important part of the rehabilitation program. Neuromuscular Electrical Stimulation (NMES) is considered one of the methods for increasing quadriceps muscle strength. To evaluate the effectiveness of combined NMES and strengthening exercises to improve the recovery of quadriceps strength and function in patients with PFPS. Methods: This study was planned as a randomized controlled pilot study. A total of 27 patients (mean age=38.9±10.8 years, range=20-60 years; 16 females) with PFPS were assessed and randomly assigned into 2 groups. Group I received a standard program (quadriceps strengthening, hip strengthening and hamstring stretching) and NMES combined with quadriceps strengthening exercises simultaneously. Group II received the same standard program without NMES. Both groups were enrolled 3 times per week for 40 minutes per day in 6 weeks. Patients were assessed at the baseline, 3 rd, 6th, and 12th weeks of treatment. Quadriceps strength was evaluated by isokinetic dynamometer. The range of motion at testing was set between 0 for extension to 90 for flexion. The test was performed at 60 degrees/sn and concentric maximum peak torque value was recorded. Kujala and Lysholm scores were used for functional assessments. The data were analyzed using the SPSS 20.0. Shapiro-Wilk test was used to assess the distribution of data. The changes in dependent variables before treatment, 3 rd, 6th, and 12th weeks were analyzed using a 2 by 4 mixed-model analysis of variance (ANOVA). Pairwise comparisons with paired t test were used to determine whether the Group I or Group II, has changed over time. An intention- to- treat analysis was performed to impute values for missing data. An alpha level of 0.05 was established. Results: The study was completed with 20 patients. Group I (n=10; mean age=39.4±8.5 years; 7 females) and group II (n=10; mean age=43.2±11.7 years; 5 females) had no differences in pre-operative measures (p>.05). There was significant improvements in within groups statistics of all parameters for both groups (p<.05). No differences in quadriceps strength, Kujala and Lysholm scores between groups were found at the different time points (F= 0.86; p = 0.12, F=0,001; p =0.97, F=0.12; p=0.73, respectively) Conclusion: NMES combined with quadriceps strengthening exercises has no additional effect on PFPS patients’ on muscle strength and function. When considering these results, we believe that there is no need to continue the study in progress. [Table: see text]


2020 ◽  
Vol 73 (4) ◽  
pp. 638-641
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets

The aim of the study was to conduct a comparative evaluation of the effectiveness of surgical treatment of acute ascending thrombophlebitis of the great saphenous vein using the endovascular high-frequency welding technique and traditional phlebectomy. Materials and methods: Two groups were formed in the conducted study. Group I included patients (n=42) with the acute ascending thrombophlebitis of the great saphenous vein, in whom their thrombosed great saphenous vein was removed using the endovascular high-frequency welding technique. As a source of current, an EK300M1 Svarmed electric welding machine (Ukraine) was used. Electric welding of a thrombosed vein segment was carried out using the endovenous electric welding catheter. Group II included patients (n=31) with the acute ascending thrombophlebitis of the great saphenous vein, who underwent the traditional phlebectomy of the thrombosed great saphenous vein according to Babcock’s technique. Results: In group I no patient revealed presence of pain syndrome with significant intensity during the postoperative period. An infiltrate along the coagulated segments of the great saphenous vein, postoperative oedema and paresthesiae were observed in considerably fewer cases from group I versus group II (р=0.0005, р=0.0001, р=0.0018). During their follow-up for more than 12 months, 2 (4.76 %) of 42 patients from group I revealed partial recanalization of the great saphenous vein (р=0.632). In group I the postoperative inpatient period was 1.3±0.1 days. In group II the above period averaged 4.8±0.8 days (p<0.001). Absence of an intense pain syndrome in group I was caused by a gentle effect of high-frequency electric current itself on the venous wall and paravasal structures. A significant reduction of side effects and complications with a shorter stay of patients in hospital versus the traditional phlebectomy was achieved owing to reduction in the extent of injury of the surgical operation itself with the use of endovascular high-frequency welding. Conclusions: The technique of endovascular high-frequency welding in treatment of acute ascending thrombophlebitis of the great saphenous vein makes it possible to reduce the extent of injury of the surgical operation versus the traditional phlebectomy, results in a significant decrease in the number of side effects and complications and shortens the period of the patient’s stay in hospital.


2010 ◽  
Vol 3 ◽  
pp. CMAMD.S4461 ◽  
Author(s):  
Hanan Mohamed Farouk ◽  
Afaf Abdel Alim Mostafa ◽  
Sahar S. Youssef ◽  
Moataz Mohammed Samy Elbeblawy ◽  
Naglaa Youssef Assaf ◽  
...  

Objective To evaluate the utility of entheseal ultrasonography and serum COMP in the preclinical diagnosis of psoriatic arthritis. Methods 60 psoriatic patients were divided into: 30 patients with psoriasis (group I) and 30 patients with psoriatic arthritis as control (group II). They underwent independent clinical and ultrasonographic examination of both lower limbs at the calcaneal insertions of Achilles tendons. Psoriatic arthritis disease activity and severity was assessed by modified DAS28 and Steinbrockers scores. Serum levels of COMP were measured for all patients by ELISA. Results On clinical examination, no entheseal abnormalities were detected in group I while they were present in 23.3% of group II with statistically significant difference between them ( P < 0.001). Ultrasonographic entheseal abnormalities were detected in 33.3% of group I and in 46.7% of group II with no significant difference between them ( P > 0.05). Serum COMP were significantly elevated in group I and II with no statistically significant difference between them (mean ± SD 5.9 ± 3 and 6.8 ± 12 respectively, P > 0.05). Entheseal ultrasound was more specific (67%) while serum COMP was more sensitive (87%) in the preclinical diagnosis of psoriatic arthritis. Serum COMP levels were significantly correlated with CRP in both groups and with DAS28 and Steinbrockers scores in group II ( P < 0.01). Conclusion Entheseal ultrasonography and serum COMP levels may be used complementary to each other for preclinical diagnosis of psoriatic arthritis. Serum COMP seems to be promising prognostic marker for psoriatic arthritis patients.


2019 ◽  
Vol 35 (4) ◽  
pp. 659-668 ◽  
Author(s):  
Mikael Koskela ◽  
Elisa Ylinen ◽  
Helena Autio-Harmainen ◽  
Heikki Tokola ◽  
Päivi Heikkilä ◽  
...  

Abstract Background In Henoch–Schönlein nephritis (HSN), a risk factor for unfavorable outcome is prolonged proteinuria, but the value of renal biopsies in prognosis assessment is debatable. Methods We evaluated serial renal biopsies from 26 HSN patients. Follow-up biopsy occurred at median 2.1 years after diagnostic biopsy. Patients formed two groups at the follow-up biopsy: patients without proteinuria (group I; n = 11) and with proteinuria (group II; n = 15). Biopsies underwent evaluation according to three classifications: International Study of Kidney Disease in Children (ISKDC), Oxford (MEST-C), and semiquantitative classification (SQC) including an activity and chronicity score. Analysis also included expression of pro-fibrotic (alpha-smooth muscle actin and vimentin) and inflammatory (P-selectin glycoprotein ligand-1) molecules in the diagnostic biopsy specimens. Definition of unfavorable outcome was active renal disease or reduced renal function at last follow-up. Results Between the biopsies, SQC chronicity score increased in 22 (85%) patients, whereas activity score and ISKDC grade decreased in 21 (81%) and 17 (65%), respectively. Of the MEST-C parameters, endocapillary proliferation (from 83 to 13%; p < 0.001) and crescents (from 63 to 25%; p = 0.022) showed significant reduction, and segmental glomerulosclerosis (from 38 to 79%; p = 0.006) significant increment. These changes occurred similarly in groups I and II. Expression of the pro-fibrotic and inflammatory molecules showed no clinically significant differences between groups I and II. None in group I and five (33%) patients in group II had unfavorable outcome (p = 0.053). Conclusions Our results suggest that follow-up biopsies provide limited additional information to clinical symptoms in HSN outcome prediction.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
David R. Burnett ◽  
Naira H. Campbell-Kyureghyan ◽  
Robert V. Topp ◽  
Peter M. Quesada

The effect of joint pathologies, such as unilateral knee osteoarthritis (UKOA) or low back pain (LBP), on bilateral gait symmetry has gained increased attention during the past decade. This study is the first to compare gait patterns between patients with UKOA and LBP in combination and with UKOA only. Temporal, kinematic, and kinetic variables were measured bilaterally during gait stance phase in 31 subjects with UKOA and LBP (Group I) and 11 subjects with only UKOA (Group II). Group I patients exhibited less hip rotation in the affected limb (A) than in the nonaffected (NA) limb during walking in contrast to Group II patients. Group I patients had minimal bilateral differences in hip abduction and flexion, but Group II patients displayed significantly larger values in the NA limb compared to the A limb for both parameters. Hip flexion patterns were significantly different between Groups I and II. Subjects in both groups adapted gait patterns that minimized vertical ground reaction force, knee flexion motion, and stance time on the UKOA affected limb. The distinct kinematic gait patterns that were revealed in this study may provide clinical value for assessment of patients with UKOA in conjunction with LBP.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Bing Li ◽  
Chuan Liu ◽  
Lang Wang ◽  
Yang Li ◽  
Yong Du ◽  
...  

Objective. This study was designed to compare the effects of catheter drainage alone and combined with ozone in the management of multiloculated pyogenic liver abscess (PLA). Methods. The prospective study included 60 patients diagnosed with multiloculated PLA. All patients were randomly divided into two groups: catheter drainage alone (group I) and catheter drainage combined with ozone (group II). Drainage was considered successful when (1) the abscess cavity was drained and (2) clinical symptoms were resolved. Kruskal-Wallis nonparametric test was used to compare the success rates, length of stay (LOS), and need for further surgery of the two groups. P<0.05 indicates significant difference. Results. All patients’ catheters were successfully placed under CT guidance. Group I was treated with catheters alone and group II was treated with catheters and ozone. The success rates of groups I and II were 86% and 96%, respectively (P<0.05). And compared with group II, the duration of fever in group I was longer (P<0.05), and the LOS was also longer (P<0.05). Conclusion. Catheter drainage combined with ozone is an effective and safe treatment in multiloculated PLA. The Clinical Registration Number is ChiCTR1800014865.


2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>


Health of Man ◽  
2021 ◽  
pp. 27-32
Author(s):  
Volodymyr Trishch ◽  
Andrii Mysak

Among men of working age, chronic prostatitis is the most common urological disease, and its inherent symptoms are a common reason for seeking urological care. To date, there is no single universal successful therapy for chronic prostatitis. Therefore, it justifies the further search for new methods of treatment of patients with this pathology. The objective: the aim of the study was to evaluate the effectiveness of immunomodulatory therapy in treatment of patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS (NIH IIIA)). Materials and methods. Under observation there were 78 patients with chronic nonbacterial prostatitis, with inflammatory chronic pelvic pain syndrome (NIH IIIA), with a disease duration of more than 2 years and low effectiveness of treatment on the background of standard therapy. All patients received standard therapy according to the clinical protocol. Some patients (group 58-II) on the background of standard therapy were additionally prescribed Overin (cridanimod sodium salt 250 mg/2 ml in 1 amp.) From the pharmaceutical company “Geolik Pharm Marketing Group” 2 ml intramuscularly once a day every 48 h, 10 injections, followed by a comparative evaluation of clinical results relative to the control group of patients (group 20 – I) who received only standard therapy, immediately after treatment and 6 months after treatment. Results. It was found that the use of standard therapy, Overin, in patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS – NIHIII A), contributed to a longer and lasting clinical effect, in contrast to the results in the group of patients who received only standard therapy. According to the assessment of the general condition (S+QoL) in group I of patients after treatment and 6 months after the standard course of treatment, the indicator improved by 38.5 and 30.9 %, respectively (p<0.05). Whereas in group II of patients, the score (S+QoL) after treatment after 6 months was 52.8 % and 49.1 % lower than before treatment (p<0.05). Overin has also been shown to be more effective in terms of the severity of the inflammatory process according to the results of prostate secretion microscopy. Lack of inflammatory activity in the prostate, in the presence of less than 10 leukocytes in the field of view at microscopy of its secretion in patients of group I after treatment was observed in 55 %, after 6 months in 45 % of patients, respectively in group II was in 77.3 % after treatment and in 75 % of patients 6 months after treatment. A more visible positive dynamics of immune status in the second group of patients was obtained. Namely, after treatment, there was a probable increase in IFN-γ in the blood by 29.9 % and a decrease in IL-6 by 2.7 times (in ejaculate by 3.2) while maintaining the visible dynamics compared to input data before treatment after 6 months (p<0.05). Whereas in the blood of patients of group I IFN-γ increased after treatment by only 5.5 % and IL-6 decreased by 24.0 % (ejaculate by 22.9 %). The level of sІgA in the ejaculate of patients of group I after treatment increased by 15.7 %, while in group II by 30.2 % (p<0.05). After 6 months, the studied indicators of immune status in the blood and ejaculate of patients of group I, visibly did not differ from the data in this group before treatment (p>0.05). Conclusions. The use of Overin on the background of standard therapy in patients with inflammatory form of CP/CPPS, contributes to a stable and long-lasting clinical effect, which is confirmed by the dynamics of the obtained clinical and laboratory data.


2013 ◽  
Vol 12 (6) ◽  
pp. 15-20
Author(s):  
G. G. Ivanov ◽  
M. Yu. Orkvasov ◽  
G. Khalabi

Aim. To study the effectiveness of the external cardiosynchronous electromyostimulation (ECSEMS) in patients with different variants of acute heart failure (AHF).Material and methods. The study included 62 AHF patients: Group I — those receiving only standard pharmacological therapy; and Group II — those in whom standard pharmacological therapy was ineffective after 12 hours, and who were also administered ECSEMS sessions for the next 7 days. The examination included multi-frequency bio-impedance measurement and dispersion mapping.Results. Clinical symptoms were less severe in Group I. In 64% of the Group II patients, the combination treatment was associated with a positive dynamics of the water balance parameters. The 7-day ECSEMS, as a part of the complex management of AHF patients, significantly reduced the one-month lethality, although did not change the one-year survival.Conclusion. The ECSEMS method could be used in order to increase the effectiveness of the conservative treatment of AHF patients. 


2018 ◽  
pp. 48-53 ◽  
Author(s):  
B. M. Belik ◽  
A. N. Kovalev ◽  
A. L. Khatlamadzhiyan

OBJECTIVES OF RESEARCH. To assess the clinical effectiveness of phlebotrophic drug Detralex (Micronized purifiedflavonoid fraction (MPFF)) during complex treatment of patients with acute hemorrhoids. MATERIALS AND METHODS. A comparative analysis of treatment outcomes of 293 patients with acute hemorrhoids was conducted. All patients were divided into two groups for further clinical observations. Standard drug therapy was performedfor 145 patients (group I). For 148 patients (group II), in addition to the standard treatment, phlebotrophic drug Detralex was additionally initiated. Research program included detection of content of acute inflammatory phase reactants and pro-inflammatory cytokines in blood plasma, evaluation of pain syndrome severity (VRS) and quality of life parameters (SF-36 questionnaire). RESULTS. Initiation of MPFF with complex treatment of patients with acute hemorrhoids was found to be contributed to faster elimination of edema and inflammation, a decrease in severity of hemorrhoids thrombosis, relief of pain syndrome and improvement in patients'quality of life, along withwell-marked regression of laboratory markers of inflammatory reaction This allows to increase the number of good outcomes of acute hemorrhoids treatment from 66,2% to 89,9%, that is by 23,7% and to reduce the number of unsatisfactory outcomes from 4,2% to 1,3%, that is by 2,9%. CONCLUSION. Inclusion of Detralex into program of acute hemorrhoids treatment contributes to a faster elimination of clinical and laboratory manifestations of the disease and allows improving the results of treatment for this category of patients.


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