An uncommon presentation of varicose vein: Special manifestations of heart disease

Pulsating varicose veins are a very rare clinical manifestation and mostly have been reported with tricuspid regurgitation or right ventricular dysfunction. The exact etiology and treatment options for this disease are rarely reported in the literature. In this article, we described a 45-year-old woman who had varicose veins in her both lower limbs when she came to our department. Venous ultrasound showed arterial-like pulsations in both superficial and deep veins of the lower extremities, and echocardiography showed severe tricuspid regurgitation. We gave the patient compression therapy for elastic stockings, and the patient's symptoms were significantly relieved. In addition, in this article, we reviewd other cases reported in the current literature and discussed appropriate treatment options for this disease

Postoperative Low Molecular Weight Heparin-induced Infection in Gastrointestinal Cancer Patients. A 2-year Single Centre Experience

Introduction: Patients with gastrointestinal cancer are at high risk of developing thrombosis and postoperative infection. Antico-agulation therapy for such patients is provided by low molecular weight heparin (LMWH) and elastic stockings. The latter, however, is linked to immunoregulatory activities and immunosuppression in vivo and in vitro. Aim: Therefore, the present study aimed to examine the link between LMWH and infection in patients with gastrointestinal cancer. Materials and methods: The study is a retrospective report of 51 patients operated on at the Second Department of Surgery at Metaxa Cancer Hospital. The sample was divided into groups based on the presence or absence of diabetes and preoperative anticoagu-lation therapy. Afterwards, the data were statistically analysed.  Results: The results of the study show a statistically significant correlation between LMWH and infection. Moreover, the risk of infec-tion increases by 13.3% for each day of heparin intake. The theory of this correlation is explained in detail.  Conclusions: The findings of the present study raise an essential question about postoperative management of cancer patients. How-ever, the study sample size is rather small so further studies with larger sample size are required to give greater credence to results.

Radiation induced vasculitis of iliac veins: presentation of a case and therapeutic dilemmas

A case of radiation-induced venous stenosis (phlebitis) after pelvic irradiation in a patient with prostate cancer is reported. Progressive swelling of both lower limbs developed due to bilateral external iliac vein stenosis. Conservative treatment with new oral anticoagulants and elastic stockings was conducted with clinical improvement of symptoms. Serial duplex scanning with trimestral frequency reveals no other progression of stenosis and the patient is well 2 years after diagnosis. Lack of data in the current literature makes management of this disease problematic.

Evaluation of a Novel Class 2 Graduated Elastic Compression Garment Compared to a Gold Standard Compression Garment

Background: Graduated elastic compression stockings are a frequently prescribed therapy for cardiovascular conditions with established benefit. However patient compliance remains low owing to significant difficulty donning the device, discomfort and poor fit. Based on end-user feedback, a novel compression device (CompressRite CR) to facilitate one handed application with minimal use of upper extremity strength was compared to Jobst stocking (Control). Methods: An open, prospective, single-center study was done in in volunteers and in-patients. Study subject’s lower extremities were clinically classified by a blinded vascular specialist. Pressure readings were obtained using a pressure sensor in standing position every 5 minutes during two 30-minute sessions using CR and Control. Results: Ninety study subjects (82 healthy volunteers, 8 in-patients, 34% males, 66% females, 70% White, 22% African American, %7 Asian, 1% Hispanic) completed the study. Clinical vascular classification revealed 31% C0, 18% C3, 16% C1, 7% C2, 4% C4 and 22% unclassified. CR performed similar to Control in terms of pressure delivery. Calf circumference was not impacted by pressure sessions in both groups. Application time of CR was higher but removal times were similar. Qualitative feedback collected showed that CR was superior to conventional garment. Conclusion: CR appeared to be equally effective to Control graduated elastic stockings with a longer application time on first attempt but consistently higher scores for satisfaction. This may represent an attractive alternative with higher patient compliance rates.