scholarly journals Small saphenous vein and acute varicose thrombophlebitis in lower limbs

2014 ◽  
Vol 18 (1 (69)) ◽  
Author(s):  
R. V. Sabadosh ◽  
O. V. Pyptiuk ◽  
A. Ye. Bohush ◽  
V. D. Skrypko ◽  
M. D. Ryziuk ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Treatment Effects ◽  
Lower Limbs ◽  
Saphenous Veins ◽  
Number Of Patients ◽  
Significant Difference ◽  
Frequent Presence

In order to compare the role of the small and great saphenous veins (SSV and GSV) in the development of acute varicose thrombophlebitis in the lower limbs (AVTLL), 236 patients with thrombotic process in 250 limbs have been examined. The number of frequency of thrombosis among the limbs with reflux both in SSV and in GSV presented the role of these veins at AVTLL most objectively. According to this value, there was no statistically significant difference betweenSSV and GSV (p=0,669): 49,0 % (95 % CI 34,8-63,4 %) versus 45,1 % (95 % CI 31,1-59,7 %). This result showed that traditionally declared higher frequency of thrombosis in GSV among the total number of patients with AVTLL was caused by the more frequent presence of abnormal reflux in this vein solely. The frequency of thrombosis in the tributaries of GSV was significantly higher than the frequency of thrombosis in SSV tributaries, regardless of groups which were compared (all p<0.05). Results of the study indicate that the role of SSV at AVTLL is often underestimated, and a thorough examination of the pathology of its system can improve the treatment effects of the patients with AVTLL.

S-Adenosylmethionine Supplementation May Reduce Cancer-Related Fatigue: A Prospective Evaluation Using the FACIT-F Questionnaire in Colon Cancer Patients Undergoing Oxaliplatin-Based Chemotherapy Regimens

Chemotherapy ◽  
2021 ◽  
pp. 1-8
Author(s):  
Angelo Onorato ◽  
Andrea Napolitano ◽  
Silvia Spoto ◽  
Lorena Incorvaia ◽  
Antonio Russo ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Cancer Patients ◽  
Chronic Fatigue ◽  
University Campus ◽  
Cancer Related Fatigue ◽  
Number Of Patients ◽  
Significant Difference ◽  
The University ◽  
Oncologic Treatment

<b><i>Background:</i></b> Fatigue is a common distressing symptom for patients living with chronic or acute diseases, including liver disorders and cancer (<i>Cancer-Related Fatigue</i>, CRF). Its etiology is multifactorial, and some hypotheses regarding the pathogenesis are summarized, with possible shared mechanisms both in cancer and in chronic liver diseases. A deal of work has investigated the role of a multifunctional molecule in improving symptoms and outcomes in different liver dysfunctions and associated symptoms, including chronic fatigue: S-adenosylmethionine (SAM; AdoMet). The aim of this work is actually to consider its role also in oncologic settings. <b><i>Patients and Methods:</i></b> Between January 2006 and December 2009, at the University Campus Bio-Medico of Rome, 145 patients affected by colorectal cancer in adjuvant (<i>n</i> = 91) or metastatic (<i>n</i> = 54; <i>n</i> = 40 with liver metastases) setting and treated with oxaliplatin-based regimen (FOLFOX for adjuvant and bevacizumab + XELOX for metastatic ones), 76 of which with the supplementation of S-adenosylmethionine (AdoMet; 400 mg b.i.d.) (57% of adjuvant patients and 44% of metastatic ones) and 69 without AdoMet supplementation, were evaluated for fatigue prevalence using the Functional Assessment of Chronic Illnesses Therapy-Fatigue (FACIT-F) questionnaire, at 3 and 6 months after the beginning of oncologic treatment. Notably, the number of patients with liver metastases was well balanced between the group of patients treated with AdoMet and those who were not. <b><i>Results:</i></b> Among patients receiving oxaliplatin-based chemotherapy, both in adjuvant and in metastatic settings, after just 3 months from the beginning of chemotherapy, mean scores from questionnaire domains like FACIT-F subscale (7.9 vs. 3.1, <i>p</i> = 0.006), FACIT physical (6.25 vs. 3.32, <i>p</i> = 0.020), FACIT emotional (4.65 vs. 2.19, <i>p</i> = 0.045), and FACIT-F total score (16.5 vs. 8.27, <i>p</i> = 0.021) were higher in those receiving supplementation of AdoMet, resulting in reduced fatigue; a significant difference was maintained even after 6 months of treatment. <b><i>Discussion and Conclusions:</i></b> Mechanisms and strategies for managing CRF are not fully understood. This work aimed at investigating the possible role of S-adenosylmethionine supplementation in improving fatigue scores in a specific setting of cancer patients, using a FACIT-F questionnaire, a well-validated quality of life instrument widely used for the assessment of CRF in clinical trials.

Correlation between expression of MCM6, a new proliferative marker, and treatment outcome in patients with Hodgkin's disease

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19547-e19547
Author(s):  
K. Khodadad ◽  
S. Karimi ◽  
Z. Esfahani Monfared
Keyword(s):  
Treatment Outcome ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
G1 Arrest ◽  
Number Of Patients ◽  
Significant Difference ◽  
Proliferative Marker

e19547 Background: MCM6 is a proliferative marker, which in contrary to Ki67, is involved in all cell cycle phases, including early G1. We evaluated MCM6 expression in Hodgkin's disease (HD) patients in order to find any correlation between MCM6 expression and treatment outcome. Methods: Formalin-fixed paraffin-embedded lymph node specimens of 55 patients with HD treated with ABVD regimen (± radiotherapy) were assessed for MCM6 expression by IHC. The percentage of nuclear positivity in RS and mononuclear Hodgkin cells was evaluated in each case. Clinical data, response to treatment and relapse rates were obtained from patients’ medical records. These data were analyzed by SPSS software. Results: Mean MCM6 expression was 80.7% (ranging 35%-99%) with no significant difference between histology subtypes. In univariate analysis, MCM6 expression was not statistically significant for B-symptoms (P=0.27), sex (P=0.91), stage (P=0.18) and response to treatment (P=0.53), but was significant for age (P=0.008) (≤23 vs >23 yrs old). The MCM6 mean expression between relapsed and non-relapsed groups was marginally significant (21% vs 29.4%, P=0.057). In multivariate analysis, we evaluated MCM6 expression, B-symptoms, stage, response rate and age for relapse. None of risk factors were statistically significant predictor for relapse, including MCM6 expression (P=0.238), however, were significant regarding to response (P<0.001) and stage (P=0.048). We divided patients in 4 quartiles based on their MCM6 expression (Q1<74.25%, N=13, Q2=74.26–85.5%, N=14, Q3=85.6–91.75%, N=13, Q4>91.75%, N=12). Relapse and PFS were not significantly different between these quartiles (P=0.27 and P=0.83, respectively). Conclusions: Our study on a limited number of patients revealed MCM6 is not a strong predictor for treatment outcome in patients with HD. Our findings can be possibly explained by early G1 arrest of tumor cells and the role of cytokine production in pathogenesis of HD. We believe determining the accurate predictive role of proliferative markers needs to be focused on the markers which are exclusively involved in S phase. No significant financial relationships to disclose.

Compression stocking prevents increased venous retrograde flow time in the lower limbs of pregnant women

2020 ◽  
Vol 35 (10) ◽  
pp. 784-791
Author(s):  
Orlando Adas Saliba Junior ◽  
Hamilton Almeida Rollo ◽  
Orlando Saliba ◽  
Marcone Lima Sobreira
Keyword(s):  
Pregnant Women ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Intervention Group ◽  
Lower Limbs ◽  
Control Group ◽  
Venous Reflux ◽  
Compression Stockings ◽  
Reflux Time ◽  
Significant Difference

Objectives To analyze the effect of graduated compression stockings on the venous reflux in the lower limbs of pregnant women. Method A controlled randomized clinical trial was performed with sixty women: intervention group (n = 30), who used compression stockings, and control group (n = 30). Using duplex-ultrasound, the reflux time and peak reflux velocity in the great saphenous vein and small saphenous vein were analyzed. Results Great saphenous vein reflux times in the intervention group were 0.13 s at the beginning (initial) and 0.04 s at the end of pregnancy (final) in the right leg and 0.02 s and 0.34 s (p < 0.0001) in the control group. No patient in the intervention group experienced pathological reflux at the end of the pregnancy. There was a significant difference in the reflux time measured from both the great saphenous vein and small saphenous vein and peak reflux velocity between the groups. Conclusion Compression stockings prevent increased venous reflux in lower limbs of pregnant women.

scholarly journals Role of cytohormonal study in normal pregnancy and in threatened abortion

2018 ◽  
Vol 7 (5) ◽  
pp. 1735
Author(s):  
Shailesh B. Patil ◽  
Milind B. Patil
Keyword(s):  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Control Group ◽  
Vaginal Smear ◽  
Age Group ◽  
Number Of Patients ◽  
Significant Difference ◽  
Parity Number ◽  
Threatened Abortion

Background: It is certain from clinical experience of many that one or more hemorrhages in early pregnancy can still end up in good fetal outcome. So, our study deals with comparison of cytohormonal study in pregnancy and threatened abortion. The study was conducted with the aim of utilizing colpocytogram as a tool in assessing and treating cases of threatened abortion and comparing them with normal pregnant women.Methods: Patients attending antenatal care unit on outdoor basis and labelled as normal pregnancy cases were considered as control group. The patients of threatened abortion were studied when they were admitted in Gynecology department for indoor treatment. Patients were studied taking into consideration their age, parity, number of abortions, complaints (P/V bleeding, pain in abdomen), gestational age, per abdomen and per vaginal findings and also USG findings and vaginal smear pattern.Results: Maximum number of patients was present in the age group of 21-25 years in both the groups. While only 13.33% had normal smear pattern in threatened abortion group. 86.67% patients in threatened abortion group showed abnormal smear pattern. There is statistically significant difference was found (p<0.05). There is statistically significant was found (P<0.01) and indicates good effects of the drug on the vaginal epithelium.Conclusions: The cytohormonal study acts as a simple, reliable, good, noninvasive method for evaluation of hormonal pattern in normal pregnancy and threatened abortion. 

scholarly journals Varicocele treatment: A 2-centers comparison between non microsurgical open correction, laparoscopic approach and retrograde percutaneous sclerotization on 463 cases

2013 ◽  
Vol 85 (3) ◽  
pp. 143 ◽  
Author(s):  
Giangiacomo Ollandini ◽  
Giovanni Liguori ◽  
Stanislav Ziaran ◽  
Tomáš Málek ◽  
Giorgio Mazzon ◽  
...  
Keyword(s):  
Sperm Count ◽  
Laparoscopic Approach ◽  
Sperm Parameters ◽  
Age Related ◽  
Number Of Patients ◽  
Significant Difference ◽  
Bivariate Regression ◽  
Open Surgical Procedure ◽  
Bivariate Regression Analysis

Objectives: To determine whether there are differences in sperm parameters improvement after different varicocele correction techniques. To determine the role of age in sperm parameters improvement. Methods: 2 different European centers collected pre- and postoperative sperm parameters of patients undergoing varicocele correction. Among 463 evaluated patients, 367 were included. Patients were divided in procedure-related and age-related groups. Ivanissevich inguinal open surgical procedure (OS), lymphatic-sparing laparoscopic approach (LSL) and retrograde percutaneous transfemoral sclerotization (RPS) were performed. As outcome measurements sperm count (millions/mL, SC) and percentage of mobile sperms were analyzed. Univariate and multivariate regression between the defined groups; bivariate regression analysis between age and sperm count and motility. Results: Number of patients: OS 78; LSL 85; RPS 204. Mean age 30.2 (SD 6.83); postoperative SC increased from 18.2 to 30.1 (CI 95% 27.3-32.9; p &lt; 0,001); motility from 25.6 to 32.56% (30.9-34.2; p &lt; 0.001). OS: SC varied from 16.9 to 18.2 (p &lt; 0.001); sperm motility from 29% to 33% (p &lt; 0.001). LSL: SC from 15.5 to 17.2 (p &lt; 0.001); motility from 27 to 31% (p &lt; 0.001). RPS: SC from 18.9 to 36.2 (p &lt; 0.001); motility from 24% to 32% (p &lt; 0.001). Univariate and multivariate analysis confirmed the significant difference of SC variation in RPS, compared to the other groups (p &lt; 0.001). No significance between LSL and OS (p = 0.826). No significant differences regarding motility (p = 0.8). Conclusions: Varicocele correction is confirmed useful in improving sperm parameters; sclerotization technique leads to a better sperm improvement compared to other studied procedures; improvement in seminal parameters is not affected by age of the patients treated.

scholarly journals Prognostic Role of the Removed Vaginal Cuff and Its Correlation with L1CAM in Low-Risk Endometrial Adenocarcinoma

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 34
Author(s):  
Enrico Vizza ◽  
Valentina Bruno ◽  
Giuseppe Cutillo ◽  
Emanuela Mancini ◽  
Isabella Sperduti ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Endometrial Adenocarcinoma ◽  
Low Risk ◽  
Consensus Guidelines ◽  
Prognostic Role ◽  
Vaginal Cuff ◽  
Number Of Patients ◽  
Significant Difference ◽  
Retrospective Data Collection

Objective: The aim of our study was to investigate the role of the excised vaginal cuff length as a prognostic factor in terms of DFS and recurrence rate/site, in low-risk endometrial cancer (EC) patients. Moreover, we correlated the recurrence with the expression of L1CAM. Material and Methods: From March 2001 to November 2016, a retrospective data collection was conducted of women undergoing surgical treatment for low-risk EC according to ESMO-ESGO-ESTRO consensus guidelines. Patients were divided into three groups according to their vaginal cuff length: V0 without vaginal cuff, V1 with a vaginal cuff shorter than 1.5 cm and V2 with a vaginal cuff longer than or equal to 1.5 cm. Results: 344 patients were included in the study: 100 in the V0 group, 179 in the V1 group and 65 in the V2 group. The total recurrence rate was 6.1%: the number of patients with recurrence was 8 (8%), 10 (5.6%) and 3 (4.6%), in the V0, V1 and V2 group, respectively. No statistically significant difference was found in the recurrence rate among the three groups. Although the DFS was higher in the V2 group, the result was not significant. L1CAM was positive in 71.4% of recurrences and in 82% of the distant recurrences. Conclusions: The rate of recurrence in patients with EC at low risk of recurrence does not decrease as the length of the vaginal cuff removed increases. Furthermore, the size of the removed vaginal cuff does not affect either the site of recurrence or the likelihood of survival.

scholarly journals Variants of Localization and Extension of Hypo- and Aplasia of the Great Saphenous Vein in Patients with Primary Varicose Great Saphenous Veins

2019 ◽  
Vol 25 (2) ◽  
Author(s):  
Rostyslav Sabadosh
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Lower Limbs ◽  
Ultrasound Scan ◽  
Saphenous Veins ◽  
Vein Segment ◽  
Surgical Tactics ◽  
The Relationship

The objective of the research was to improve the diagnostics and treatment of patients with primary varicose great saphenous veins by studying their frequency and systematizing the variants of localization and extension of great saphenous vein hypoplasia and aplasia in its trunk. Materials and Methods. The study included 560 patients with varicose veins of the lower limbs and pathological refluxes in different segments of the great saphenous vein. All the patients underwent triplex ultrasound scan of the lower limb venous system. Results. Among the patients with pathological reflux in a certain GSV segment, hypo- and aplasia of its segments were observed in 32.5% of the cases (95% CI 28.6-36.6%). Aplasia of this vein was observed twice as less frequently than hypoplasia (p<0.05). In 2.3% of the cases (95% CI 1.2-3.9%), hypoplasia of a certain GSV segment evolved to aplasia, or vice versa. It was found that the GSV trunk may have several hypo- or aplastic regions separated by its normal or varicose segment – bi-level hypo- or aplasia that was observed in 3.8% of the patients with hypo- or aplasia (95% CI 1.6-7.8%). In bi-level hypo- or aplasia, 2 hypoplastic regions were detected in 85.7% of the cases (95% CI 42.1-99.6%) and 2 aplastic regions were found in 14.3% of the cases (95% CI 0.4-57.9%). There were proposed to distinguish the following variants of GSV hypo- and aplasia: 1) simple: total, proximal, segmental and distal; 2) bi-level: proximal segmental, distal segmental and bi-segmental. In addition, for every dysplastic vein segment, the type of malformation should be indicated, namely hypoplasia, aplasia, or hypo/aplasia. Conclusions. The study conducted allowed assessing the relationship between the variants of GSV hypo- and aplastic segment localization and extension and different variations of pathological refluxes of the GSV in its trunk for further choice of surgical tactics.

546 QUALITY IMPROVEMENT PROJECT: IMPROVING CONTENT IN DISCHARGE SUMMARIES FOR CODING

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
C Alcock ◽  
P Oluwamayowa ◽  
E Wallace
Keyword(s):  
Lead Author ◽  
Junior Doctors ◽  
Improvement Project ◽  
Record Keeping ◽  
Number Of Patients ◽  
Significant Difference ◽  
Discharge Letter ◽  
Resource Group ◽  
Health Care Records

Abstract Introduction Hospital coding provides a pivotal service, integral to data collection, national statistics and hospital finances. The system of accurately coding depends almost entirely on the information put into Electronic Discharge Letters (EDLs). This project aims to up skill doctors with the expertise of the coding department, so that the EDLs reflect more accurately the experiences of the patient in hospital. Method Cycle 1; A member from the coding department was invited to the ward once a week to join with junior doctors writing their discharge letter. The coding from the discharge letters produced during this time were compared to those immediately prior to the coding department’s involvement. Cycle 2; The lead author and a member from the coding team took a sample of 12 notes from the Ambulatory Emergency Clinic (AEC), for patients presenting in January and February of 2020. Results Cycle 1; there was no significant difference in the number of co-morbidities or revenue gained from EDLs written with the support of the coding team compared to doctors writing ELDs independently Cycle 2; For 9 of the 12 patients (75%), co-morbidities were added. This changed the Healthcare Resource Group coded of 5 patients, resulting in an increasing the revenue to the hospital by £757 on average. For the number of patients seen in AEC in January, this could represent £218,271 of lost revenue, in addition to other benefits of accurate record keeping. Conclusion The role of the physician cannot increase indefinitely, and there is a wealth of knowledge and experience to be gained from our colleagues in the coding department. This collaboration in assiduously improving the service that our patients receive brings the possibility of large financial gains as well as more accurate health care records.

Echoanatomical Patterns of the Long Saphenous Vein in Patients with Primary Varices and in Healthy Subjects

1999 ◽  
Vol 14 (2) ◽  
pp. 54-58 ◽  
Author(s):  
S. Ricci ◽  
A. Caggiati
Keyword(s):  
Saphenous Vein ◽  
Healthy Subjects ◽  
Duplex Ultrasound ◽  
Normal Subjects ◽  
Predisposing Factor ◽  
Long Saphenous Vein ◽  
Saphenous Veins ◽  
Ultrasound Evaluation ◽  
Congenital Origin

Objective: To evaluate the pathway of reflux in incompetent long saphenous veins (LSVs), paying particular attention to the role of longitudinal saphenous tributaries in the thigh (accessory saphenous veins, ASVs). Design: Prospective study in a group of patients with primary varices. Comparison with the anatomical patterns in a group of normal subjects. Setting: Private phlebology practice. Patients: Sixty-seven patients with primary varices (100 limbs) and 66 subjects without varices and with competent saphenous veins (120 limbs). Methods: Duplex ultrasound evaluation of the saphenous system in the thigh of patients and healthy subjects. The ‘eye’ ultrasonographic sign was used as the marker to distinguish the LSV from the longitudinal tributary veins of the thigh. Results: In 57% of limbs in patients with varices, reflux followed the saphenous vein, while in 43% the reflux spilled outside the LSV into an ASV (h or S types). When reflux followed the saphenous vein, no large calibre ASVs could be observed. In 30% of limbs in control subjects a parallel tributary vein with a similar calibre was found joining the LSV. Conclusion: Clinically visible varices in the thigh rarely comprise the LSV itself, but are usually dilated ASVs, the reflux stream passing from the proximal LSV into a more superficial ASV. The distal LSV running parallel beneath is often competent. In subjects with healthy LSVs, a large competent tributary vein is already present in the thigh in 30% of cases. This suggests that superficial deviation of reflux flow into an ASV in patients with varices may not arise from haemodynamically acquired changes, but could have a congenital origin. This could even be a predisposing factor in the development of varices.

Dysregulated apoptosis of the venous wall in chronic venous disease and portal hypertension

2016 ◽  
Vol 31 (10) ◽  
pp. 729-736 ◽  
Author(s):  
Li Kun ◽  
Li Ying ◽  
Wang Lei ◽  
Zhao Jianhua ◽  
Xu Yongbo ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Splenic Vein ◽  
Chronic Venous Disease ◽  
Terminal Deoxynucleotidyl Transferase ◽  
Venous Disease ◽  
Apoptotic Cells ◽  
Positive Expression ◽  
Saphenous Veins ◽  
Significant Difference

Introduction The etiology of varicose veins remains elusive. We hypothesized that abnormal cell cycle events in the vein wall may contribute to changes in the structural integrity, thus predisposing to the development of varicosities. The present study was designed to determine whether or not the same molecular apoptotic pathway exists between great saphenous and splenic veins. Methods Thirty-six samples of diseased splenic veins and varicose great saphenous veins were collected. Twenty-five samples of control splenic and great saphenous veins were also collected. The apoptotic cell proteins expression was immunohistochemically stained with antibodies (anti-Bax and anti-Bcl-xl). Apoptosis was evaluated by the terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL) assay and immunofluorescence staining. The morphology of apoptotic cells was observed with an electron microscope. Results The apoptotic ratio in walls (intima and media) of diseased splenic vein and varicose great saphenous vein groups were significantly lower than the corresponding regions in the splenic vein and great saphenous vein groups ( p < 0.01), respectively. A significant difference was not noted in the ratio change of apoptotic cells between the diseased splenic vein and varicose great saphenous vein groups ( p > 0.05). The high positive expression of Bcl-xl proteins was detected in the diseased splenic vein and varicose great saphenous vein groups, respectively. While the high positive expression of Bax proteins was also observed in the splenic vein and great saphenous vein groups, respectively. Electron microscopic observations confirmed that endothelial and smooth muscle cells in diseased splenic vein, varicose great saphenous vein, splenic vein, and great saphenous vein walls exhibited apoptotic morphologic features, such as fuzzy mitochondrial cristae, medullary changes, and margination of the nuclear chromatin. Conclusions Our results showed the same dysregulation of apoptosis via the intrinsic pathway in diseased splenic veins and varicose great saphenous veins. This observational study suggests that apoptotic down-regulation in the veins wall is a cause of diseased splenic veins and varicose great saphenous veins, but does not exclude the possibility that other mechanisms are involved.

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