Type 4 Cardiorenal Syndrome: Diagnosis and Treatment

The clinical presentation of, and diagnostic approach taken for, a 63-year-old man with worsening dyspnea, chest heaviness and widespread lower limb edema, leading to a diagnosis of type 4 cardiorenal syndrome, is presented. The most appropriate approach at point of care is thoroughly discussed.

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Cardiorenal Syndrome: Diagnosis and Treatment

KIDNEYS ◽

10.22141/2307-1257.6.1.2017.93777 ◽

2017 ◽

Vol 6 (1) ◽

pp. 93777

Author(s):

O.O. Melnyk

Keyword(s):

Cardiorenal Syndrome ◽

Diagnosis And Treatment ◽

Syndrome Diagnosis

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Sonography of subcutaneous tissue cannot determine causes of lower limb edema

VASA ◽

10.1024/0301-1526/a000418 ◽

2015 ◽

Vol 44 (2) ◽

pp. 122-128 ◽

Cited By ~ 6

Author(s):

Mandy Becker ◽

Tom Schilling ◽

Olga von Beckerath ◽

Knut Kröger

Keyword(s):

Clinical Diagnosis ◽

Lower Limb ◽

Subcutaneous Tissue ◽

Hepatic Disease ◽

Clinical Use ◽

Single Image ◽

Heart Insufficiency ◽

Chronic Hepatic Disease ◽

Limb Edema ◽

Venous Disorders

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.

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Influences of lower limb edema on daily lives of elderly individuals in an elderly day care center

Japan Journal of Nursing Science ◽

10.1111/jjns.12383 ◽

2020 ◽

Author(s):

Sayumi Tsuchiya ◽

Takuto Sawazaki ◽

Shuji Osawa ◽

Makoto Fujiu ◽

Mayumi Okuwa ◽

...

Keyword(s):

Lower Limb ◽

Day Care ◽

Care Center ◽

Daily Lives ◽

Day Care Center ◽

Elderly Individuals ◽

Limb Edema

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Dermatitis herpetiformis: pathophysiology, clinical presentation, diagnosis and treatment

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20142966 ◽

2014 ◽

Vol 89 (6) ◽

pp. 865-877 ◽

Cited By ~ 17

Author(s):

Marcos Vinícius Clarindo ◽

Adriana Tomazzoni Possebon ◽

Emylle Marlene Soligo ◽

Hirofumi Uyeda ◽

Roseli Terezinha Ruaro ◽

...

Keyword(s):

Clinical Presentation ◽

Dermatitis Herpetiformis ◽

Diagnosis And Treatment

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Leg Varices Originating from the Pelvis: Diagnosis and Treatment

Vascular ◽

10.2310/6670.2006.00030 ◽

2007 ◽

Vol 15 (2) ◽

pp. 70-78 ◽

Cited By ~ 25

Author(s):

Milka Greiner ◽

Geoffrey L. Gilling-Smith

Keyword(s):

Effective Treatment ◽

Lower Limb ◽

Varicose Veins ◽

Diagnosis And Treatment ◽

Repeat Surgery ◽

Recurrent Reflux ◽

Venous Circulation ◽

Platinum Coils

This article reports the investigation and treatment of 24 women presenting with recurrent lower limb varicosities secondary to reflux within the pelvic venous circulation. Diagnosis based on selective retrograde pelvic phlebography enabled precise identification and classification of sites of incompetence. A total of 74 veins were treated by embolization with platinum coils and glue prior to repeat surgery to the lower limb veins. At 4-year follow-up, signs of stasis had disappeared in all patients. Repeat phlebography revealed no evidence of recurrent reflux at the sites of treatment. One patient developed recurrent varices due to incomplete embolization of incompetent pelvic veins. Endovascular occlusion of incompetent pelvic veins is an effective treatment for varicose veins secondary to pelvic venous incompetence.

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SUNCT Syndrome: diagnosis and treatment.

Headache The Journal of Head and Face Pain ◽

10.1046/j.1526-4610.2003.03062_17.x ◽

2003 ◽

Vol 43 (3) ◽

pp. 306-306 ◽

Cited By ~ 2

Author(s):

JA Pareja ◽

AB Caminero ◽

O Sjaastad

Keyword(s):

Diagnosis And Treatment ◽

Sunct Syndrome ◽

Syndrome Diagnosis

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Point‐of‐care ultrasound for prompt diagnosis and treatment monitoring of acute epiglottitis

Journal of General and Family Medicine ◽

10.1002/jgf2.373 ◽

2020 ◽

Vol 22 (1) ◽

pp. 51-52

Author(s):

Hiroshi Hori ◽

Takahiko Fukuchi ◽

Hitoshi Sugawara

Keyword(s):

Point Of Care ◽

Treatment Monitoring ◽

Diagnosis And Treatment ◽

Point Of Care Ultrasound ◽

Acute Epiglottitis ◽

Prompt Diagnosis

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Methionine Synthase Deficiency: Variable Clinical Presentation And Benefit Of Early Diagnosis And Treatment

Journal of Inherited Metabolic Disease ◽

10.1002/jimd.12448 ◽

2021 ◽

Author(s):

Kimberly A. Kripps ◽

Leighann Sremba ◽

Austin A. Larson ◽

Johan L.K. Van Hove ◽

Hoanh Nguyen ◽

...

Keyword(s):

Early Diagnosis ◽

Clinical Presentation ◽

Methionine Synthase ◽

Diagnosis And Treatment ◽

Variable Clinical Presentation

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Morbidity of Inguinofemoral Lymphadenectomy in Vulval Cancer

The Scientific World JOURNAL ◽

10.1100/2012/341253 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 20

Author(s):

A. A. Soliman ◽

M. Heubner ◽

R. Kimmig ◽

P. Wimberger

Keyword(s):

Saphenous Vein ◽

Lower Limb ◽

Local Complications ◽

Wound Breakdown ◽

Vulval Cancer ◽

Significant Difference ◽

Limb Edema ◽

Short And Long Term ◽

Inguinofemoral Lymphadenectomy

Background. The aim of this study is to detect possible risk factors for development of short- and long-term local complications after inguinofemoral lymphadenectomy for vulval cancer.Methods. This retrospective cohort study included 34 vulval cancer patients that received inguinofemoral lymphadenectomy. The detected complications were wound cellulitis, wound seroma formation, wound breakdown, wound infection, and limb lymphoedema. Followup of the patient ran up to 84 months after surgery.Results. Within a total of 64 inguinofemoral lymphadenectomies, 24% of the inguinal wounds were affected with cellulitis, 13% developed a seroma, 10% suffered wound breakdown, 5% showed lower limb edema within a month of the operation, and 21.4% showed lower limb edema during the long-term followup. No significant correlation could be found between saphenous vein ligation and the development of any of the local complications. The 3-year survival rate in our cohort was 89.3%.Conclusions. Local complications after inguino-femoral lymphadenectomy are still very high, with no single pre-, intra-, or postoperative factor that could be incriminated. Saphenous vein sparing provided no significant difference in decreasing the rate of local complications. More trials should be done to study the sentinel lymph node detection technique.

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