scholarly journals The Effect of Aspirin and Enoxaparin on the Prevention of Venous Thromboembolism in Patients With Ankle Sprain and Cast Immobilization: A Randomized Clinical Trial

2021 ◽  
Vol 8 (1) ◽  
pp. 9-16
Author(s):  
Mehran Razavipour ◽  
◽  
Salman Ghaffari ◽  
Mehdi Mohebi ◽  
Shayan Amjadi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Ankle Sprain ◽  
Lower Limb ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Control Group ◽  
Cast Immobilization ◽  
Enoxaparin Group ◽  
D Dimer

Background: The incidence of Venous Thromboembolism (VTE) and its prophylaxis in patients with an ankle injury and cast immobilization are controversial. Objectives: This study aimed to investigate the effect of aspirin and enoxaparin on VTE prevention in patients with an ankle sprain and cast immobilization. Methods: In a double-blind, randomized clinical trial, 90 eligible patients were divided into three groups: patients who did not receive the drugs (the control group), patients who received aspirin (325 mg/d) for 3 weeks (the ASA group), and patients who received enoxaparin (40 mg/d subcutaneously) for 3 weeks (the enoxaparin group). After 3 weeks, the plaster was opened, and the D-dimer level was measured if there was a VTE symptom during the study. Otherwise, at the end of the study, the bilateral lower-limb Complete Compression Ultrasonography (CCUS) and color Doppler ultrasound were used to image the lower limb venous system. Results: Sixty-eight patients completed the study. The mean±SD values of D-dimer in the control, ASA, and enoxaparin groups were 0.33 (0.47) μg/dL (Median=0.18 μg/dL), 0.32 (0.14) μg/dL (Median=0.3 μg/dL) and 0.32 (0.25) μg/dL (Median=0.21 μg/dL), respectively (P>0.05). The positive D-dimer was seen in 2 patients (8%) of the control group, 2 patients (8.3%) of the ASA group, and 2 patients (10.5%) of the enoxaparin group (P>0.05). The color Doppler ultrasound was negative in all patients. Conclusion: Because none of the 68 patients in the current study developed VTE during our 30 days follow-up period, it seems that prophylaxis treatment is unnecessary in patients with an ankle sprain and cast immobilization. Further studies on more patients with a longer period of follow-up are recommended.

Clinical Assistant Analysis of Color Doppler Ultrasound in Diagnosis Parameters of Chronic Heart Failure

2021 ◽  
Vol 11 (6) ◽  
pp. 1616-1622
Author(s):  
Chenwei Gao ◽  
Wei Zeng ◽  
Xueyong Li ◽  
Yingjuan Zheng ◽  
Weiliang Liu
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Treatment Effect ◽  
Predictive Value ◽  
Heart Function ◽  
Color Doppler ◽  
Myocardial Damage ◽  
Color Doppler Ultrasound ◽  
Control Group

Chronic heart failure (CHF) is a group of clinical syndromes caused by changes in myocardial structure and function caused by any reason, leading to ventricular filling and ejection disorders. It is the final stage of the development of various cardiovascular diseases. It is a progressive disease. Once it starts, even if there is no new myocardial damage, the clinic is still in a stable stage, and it can still continue to develop on its own. This article uses the comprehensive parameters of echocardiography to evaluate the overall heart function of patients with chronic heart failure, and evaluates the treatment effect of patients with chronic heart failure. A total of 160 patients with chronic heart failure were studied, including 80 cases in the follow-up group, 40 cases in the non-follow-up group, and 40 cases in the normal control group. The heart failure ultrasound index composed of the comprehensive parameters of echocardiography was used to measure brain natriureric pepride (BNP), and the heart function was graded. The results showed that when the heart failure ultrasound index value >3, the diagnosis of symptomatic chronic heart failure had a sensitivity of 94.7%, a specificity of 94.6%, a positive predictive value of 97.8%, and a negative predictive value of 80.6%. The heart failure ultrasound index was positively correlated with plasma BNP and NYHA heart function (respectively 0.68, 0.73). After 6 months of observation, the ultrasound index of heart failure in the follow-up group decreased significantly before and after treatment. The experimental results show that the heart failure ultrasound index can be used to guide the treatment of patients with chronic heart failure, evaluate the treatment effect, and evaluate the prognosis. Appropriate health education and standardized medication can improve the treatment effect of chronic heart failure and improve the quality of life of patients.

scholarly journals Evaluation of Deep Vein Thrombosis Risk Factors After Arthroscopic Posterior Cruciate Ligament Reconstruction: A Retrospective Observational Study

2021 ◽  
Vol 27 ◽  
pp. 107602962110305
Author(s):  
Pu Ying ◽  
Wenge Ding ◽  
Xiaowei Jiang ◽  
Yue Xu ◽  
Yi Xue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posterior Cruciate Ligament ◽  
Color Doppler ◽  
Cruciate Ligament ◽  
Color Doppler Ultrasound ◽  
Pcl Reconstruction ◽  
Vein Thrombosis ◽  
Post Surgery ◽  
Pcl Injury ◽  
D Dimer

We evaluated the risk factors of deep venous thrombosis (DVT) after knee arthroscopic posterior cruciate ligament (PCL) reconstruction in patients with only PCL injury. From August 2014 to December 2020, a total of 172 patients who had accepted knee arthroscopic PCL reconstruction underwent the color Doppler ultrasound of bilateral lower-extremities deep veins on 3 days postoperatively. Based on the inspection results, patients were divided into DVT group (18 males and 8 females, mean age 43.62 years) and non-DVT group (108 males and 38 females, mean age 33.96 years). The potential associations of DVT risk and age, gender, body mass index (BMI), diabetes, hypertension, smoking and other factors were analyzed. An old age (OR = 1.090; 95% CI = 1.025-1.158; P = 0.006), a high BMI (OR = 1.509; 95% CI = 1.181-1.929; P = 0.001) and an increased post-surgery D-dimer (OR = 5.034; 95% CI = 2.091-12,117; P ≤ 0.001) value were significantly associated with an elevated DVT risk after knee arthroscopic PCL reconstruction. Increased age, BMI, and postoperative D-dimer were risk factors of DVT following knee arthroscopic PCL reconstruction in patients with only PCL injury.

scholarly journals Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan
Keyword(s):  
Doppler Ultrasound ◽  
Renal Allograft ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Imaging Findings ◽  
Unenhanced Ct ◽  
Doppler Signals ◽  
History Of ◽  
Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

scholarly journals Venous leakage treatment revisited: pelvic venoablation using aethoxysclerol under air block technique and Valsalva maneuver

2015 ◽  
Vol 87 (1) ◽  
pp. 1 ◽  
Author(s):  
Ralf Herwig ◽  
Salvatore Sansalone
Keyword(s):  
Doppler Ultrasound ◽  
Valsalva Maneuver ◽  
Color Doppler ◽  
Pde5 Inhibitor ◽  
Penile Prosthesis ◽  
Cost Effective ◽  
Color Doppler Ultrasound ◽  
Pde5 Inhibitors ◽  
Venous Leakage

Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous leaks were identified by Color Doppler Ultrasound after intracavernous alprostadil injection. Under local anesthesia a 20-gauge needle was inserted into the deep dorsal penile vein. The pelvic venogram was obtained through deep dorsal venography. Aethoxysclerol 3% as sclerosing agent was injected after air-block under Valsalva manoeuver. Success was defined as the ability to achieve vaginal insertion without the aid of any drugs, vasoactive injections, penile prosthesis, or vacuum device. Additionally, a pre- and post- therapy IIEF score and a digital overnight spontaneous erections protocol (OSEP) with the NEVA™-system was performed. Results: At 3 month follow-up 77 out of 96 patients (80.21%) reported to have erections sufficient for vaginal insertion without the use of any drug or additional device. Four (4.17%) patients did not report any improvement. Follow up with color Doppler ultrasound revealed a new or persistent venous leakage in 8 (8.33%) of the patients. No serious complications occurred. Conclusions: Our new pelvic venoablation technique using aethoxysclerol in air-block technique was effective, minimally invasive, and cost-effective. All patients were able to perform sexual intercourse without the previously used dosage of PDE5 inhibitor. This new method may help in patients with contra-indications against PDE5 inhibitors, in patients who cannot afford the frequent usage of expensive oral medication or those who do not fully respond to PDE5-inhibitors.

scholarly journals Management of Secondary Prevention in Venous Thromboembolism: Use of Reduced Doses of Rivaroxaban and Apixaban in Extended Therapy

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 16-17
Author(s):  
Desiree Campoy ◽  
Katia Flores ◽  
Gonzalo Artaza ◽  
César A Velasquez ◽  
Tania Canals ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Secondary Prevention ◽  
Board Of Directors ◽  
Dose Reduction ◽  
Standard Dose ◽  
Control Group ◽  
Advisory Committees ◽  
The Mean ◽  
D Dimer

BACKGROUND After a standard anticoagulation period (3-6 months), the risk of venous thromboembolism recurrence (RVTER) needs to be considered. Such risk is higher in unprovoked events and patients with persistent risk factor. The increase of D-dimer (DD) levels during the therapy seems to be strongly associated to RVTER. The use of rivaroxaban 10 mg/day and apixaban 2.5mg/12h as an extended therapy (ET) after the standard anticoagulation period has been proven to be an effective strategy to prevent recurrence without increasing bleeding events. AIM To assess the effectiveness and safety of reduced doses of rivaroxaban and apixaban as ET in patients with RVTER and to compare their DD levels with those of a control group on anticoagulant therapy at a standard dose. METHODS From April 2016 to June 2020, we included patients with venous thromboembolism (VTE) who received ET with rivaroxaban and apixaban with/at reduced doses. Dose reduction was performed following the clinical algorithm of our unit (Fig. 1). The DD values were determined using HemosIl D-Dimer HS-500 and the cut-off value was established at 500 µg/L DD levels were compared with a control group of 235 patients with VTE who received ET with standard doses of anticoagulation. DD levels were measured at the time of diagnosis (D1), initiation of treatment (D2) and 3 months after treatment (D3). RESULTS From a total of 116 patients (65.5% women), 77.6% (n=90) received rivaroxaban 10 mg/24h and 22.4% received apixaban 2.5 mg/12h as an ET. The mean duration of the initial anticoagulant therapy was 12 +/- 8.8 months. The mean DD value prior to the ET was 388 µg/L. In this group, 63.8% (n=74) was an unprovoked VTE and 17.2% (20) had hereditary thrombophilia. The mean of follow-up time was 6.9 +/- 8.3 months. No recurrences of VTE were observed during the follow-up and only one major bleeding event was reported in a high-bleeding risk patient. We observed a progressive decrease of DD levels from the VTE diagnosis to the last visit, with D1, D2, and D3 values of 987 µg/L ± 324, 388 µg/L ± 134, and 288 µg/L ± 98, respectively. There were no differences in d-dimer concentrations between patients with reduce doses of rivaroxaban or apixaban and the control group with standard doses (D1: 85.6% vs 81%, p =0.22; D2: 10.2% vs 8.0%, p =0.14; and D3: 9.1% vs 9.5%, p =0.18). CONCLUSIONS Our data indicated that an ET strategy with reduced doses of rivaroxaban or apixaban is effective and safe. We did not observe significant differences in DD levels at follow-up compared to the control group receiving a standard dose of anticoagulation. Further studies are needed in order to select and standardize dose reduction criteria in secondary prevention. Figure 1 Disclosures Campoy: boehringer ingelheim: Consultancy; Daiichi Sankyo: Speakers Bureau. Sierra:Pfizer: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Jazz Pharmaceuticals: Research Funding; Astellas: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead-Kite: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Daiichi Sankyo: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Olivera:Daiichi Sankyo: Consultancy, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Boehringer Ingelheim: Consultancy, Speakers Bureau; BAYER: Consultancy.

scholarly journals Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250965
Author(s):  
José Roberto de Souza Júnior ◽  
Pedro Henrique Reis Rabelo ◽  
Thiago Vilela Lemos ◽  
Jean-Francois Esculier ◽  
João Pedro da Silva Carto ◽  
...  
Keyword(s):  
Lower Limb ◽  
Intervention Group ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Gait Retraining ◽  
Positive Effects ◽  
Clinical Applicability ◽  
Limb Kinematics ◽  
Lower Limb Kinematics

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14—MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.

scholarly journals Guided meditation for vision acuity training on adolescent myopia: study protocol for an open-label, prospective, multicenter, randomized controlled trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Yibo Li ◽  
Lili Zhu ◽  
Raoying Wang ◽  
Xingyue Yang ◽  
Xinqi Jiang ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Visual Acuity ◽  
Controlled Trial ◽  
Control Group ◽  
Health Maintenance ◽  
Ocular Symptoms ◽  
Thought Disorders ◽  
Multicenter Randomized Controlled Trial ◽  
Distant Visual Acuity

Abstract Background Currently, the population with myopia climbs steadily, and is developing toward younger age, posing a great concern to the health of adolescents. Myopia in severe cases can cause irreversible consequences such as glaucoma, blindness, and other complications. At present, the solutions for myopia are glasses, medication, and surgery. This study aims to investigate the role of a physiotherapy category based on guided meditation for vision acuity training on adolescent myopia. Methods This is a prospective, randomized, multicenter clinical trial. One thousand one hundred forty primary and secondary school students aged 8–18 years old from 27 schools will be recruited and randomly divided into an experimental and a control group at a ratio of 2:1 in two phases, with a training period of 30 days in each phase and a follow-up period of 3 months. No interventions will be conducted during the follow-up period, nor will other interventions employed. Inclusion criteria will meet the diagnostic criteria for simple myopia and −6.00D ≤ spherical lenses ≤ −0.50D and cylindrical lenses ≤1.50D. The primary observation index will be to compare the statistical differences in distant visual acuity between the two groups; the secondary observation indexes will be ocular symptoms (mainly including eye fatigue, dryness, pain, double vision, neck pain, thought disorders, and lags in response), diopter, and astigmatism. Discussion The purpose of this two-phase trial is to compare the clinical effectiveness of focused vision-guided meditation with Chinese eye exercises that are also non-pharmacological, non-invasive interventions for myopia, and to maximize the benefit to the subjects. The results will indicate whether the training based on focused vision-guided meditation has the ability to improve distant visual acuity, relieve ocular symptoms, and ameliorate diopter. In addition, this trial will provide clinical efficacy of the training, which is expected to provide meaningful data for vision rehabilitation. At the same time, the vision acuity training method, which is permeated with the concept of Traditional Chinese Medicine (TCM) rehabilitation and health maintenance, will be applied to achieve the goal of preventing or alleviating myopic development and reducing myopia rate. Trial registration Chinese Clinical Trial Registry ChiCTR2000038642. Registered on 26 September 2020

scholarly journals Effectiveness of a home care teaching program for prostatectomized patients: a randomized controlled clinical trial

2019 ◽  
Vol 53 ◽  
Author(s):  
Luciana Regina Ferreira da Mata ◽  
Cissa Azevedo ◽  
Mariana Ferreira Vaz Gontijo Bernardes ◽  
Tânia Couto Machado Chianca ◽  
Maria da Graça Pereira ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Home Care ◽  
Self Efficacy ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Teaching Program ◽  
Significant Difference ◽  
The Times

ABSTRACT Objective: To evaluate the effectiveness of a teaching program for hospital discharge of patients submitted to radical prostatectomy based on the self-efficacy construct of the Cognitive Social Theory. Method: A controlled clinical trial carried out on a 2-month follow-up of 68 prostatectomized men randomized into intervention group (n = 34) and control (n = 34). The intervention group received routine guidance from the service plus the teaching program. The control group only received routine guidance from the service. The data collection instruments were: sociodemographic and clinical questionnaire, self-efficacy scale, hospital depression and anxiety scale, household care knowledge questionnaire, and an item on satisfaction with a score of 1 to 5. Results: There was a significant difference between the intragroups for satisfaction (p<0.001) and knowledge (p<0.001) of the pre-test to the post-test. In the intervention group, there were significant changes between the times for anxiety (p=0.011) and knowledge (p<0.001). Conclusion: The teaching program with a combination of oral guidance, written instruction and telephone follow-up was effective in improving knowledge about home care and personal satisfaction. Brazilian Registry of Clinical Trials: RBR-5n95rm.

Marital Problems and Treatment Outcome in Depressed Women

1987 ◽  
Vol 151 (5) ◽  
pp. 652-659 ◽  
Author(s):  
Roslyn H. Corney
Keyword(s):  
Clinical Trial ◽  
Social Work ◽  
Social Workers ◽  
Control Group ◽  
Women Patients ◽  
Marital Problems ◽  
Routine Treatment ◽  
Work Intervention ◽  
Experimental Group

In a clinical trial investigating the effectiveness of social work intervention with depressed women patients in general practice, 80 women were randomly allocated to an experimental group for referral to attached social workers or to a control group for routine treatment by their GPs. They were reassessed at 6 and 12 months. The results indicated that women who had major marital problems were more likely to be depressed at follow-up than those with good relationships. However, patients with marital difficulties in the experimental group made more improvement than the controls. Women initially assessed as suffering from ‘acute on chronic’ depression and having major marital difficulties were found to benefit most from social work intervention.

scholarly journals Effects of exercise combined with whole body vibration in patients with patellofemoral pain syndrome: a randomised-controlled clinical trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Angel Yañez-Álvarez ◽  
Beatriz Bermúdez-Pulgarín ◽  
Sergio Hernández-Sánchez ◽  
Manuel Albornoz-Cabello
Keyword(s):  
Clinical Trial ◽  
Lower Limb ◽  
Repeated Measures ◽  
Whole Body Vibration ◽  
Patellofemoral Pain ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
And Function ◽  
Experimental Group

Abstract Background Patellofemoral pain is a prevalent condition in the general population, especially in women, and produces functional impairment in patients. Therapeutic exercise is considered an essential part of the conservative management. The use of vibration platforms may help improve strength and function and reduce pain in patients with knee disorders. The aim of this investigation was to determine the effects of adding whole body vibration (vertical, vibration frequency of 40 Hz, with an amplitude from 2 to 4 mm) to an exercise protocol for pain and disability in adults with patellofemoral pain. Methods A randomised clinical trial was designed, where 50 subjects were randomly distributed into either an exercise group plus whole body vibration or a control group. Pain, knee function (self-reported questionnaire) and range of motion and lower limb functionality were assessed at baseline and at 4 weeks. The experimental group performed 12 supervised sessions of hip, knee and core strengthening exercises on a vibration platform 3 times per week during 4 weeks. The control group followed the same protocol but without vibration stimuli. Differences in outcome measures were explored using an analysis of the variance of 2 repeated measures. Effect sizes were estimated using Square Eta (η2). Significant level was set al P < 0.05. Results Statistically significant differences were found after intervention in favour of the experimental group in the between-groups comparison and in the interaction of the experimental group before and after treatment in terms of pain perception (P = 0.000; η2 = 0.63) and function outcomes scores (P = 0.000; η2 0.39 and 0.51 for lower limb functional scale and Kujala scores respectively). Conclusion A 4-week whole body vibration exercise programme reduces pain level intensity and improves lower limb functionality in patellofemoral pain patients and is more effective than exercise alone in improving pain and function in the short-term. Trial registration ClinicalTrials.gov (NCT04031248). This study was prospectively registered on the 24th July, 2019.

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