Factors associated with recurrence of varicose veins after thermal ablation: results of the recurrent veins after thermal ablation study.

BACKGROUND: The goal of this retrospective cohort study (REVATA) was to determine the site, source, and contributory factors of varicose vein recurrence after radiofrequency (RF) and laser ablation. METHODS: Seven centers enrolled patients into the study over a 1-year period. All patients underwent previous thermal ablation of the great saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory great saphenous vein (AAGSV). From a specific designed study tool, the etiology of recurrence was identified. RESULTS: 2,380 patients were evaluated during this time frame. A total of 164 patients had varicose vein recurrence at a median of 3 years. GSV ablation was the initial treatment in 159 patients (RF: 33, laser: 126, 52 of these patients had either SSV or AAGSV ablation concurrently). Total or partial GSV recanalization occurred in 47 patients. New AAGSV reflux occurred in 40 patients, and new SSV reflux occurred in 24 patients. Perforator pathology was present in 64% of patients. CONCLUSION: Recurrence of varicose veins occurred at a median of 3 years after procedure. The four most important factors associated with recurrent veins included perforating veins, recanalized GSV, new AAGSV reflux, and new SSV reflux in decreasing frequency. Patients who underwent RF treatment had a statistically higher rate of recanalization than those treated with laser.

Dentists' attitudes toward continuing dental education: nontopic factors of demand for courses.

This article reports the results of a survey of dentists' attitudes that influence their demand for continuing education. Unlike the bulk of previous studies, which identified course topics of interest to dentists, this survey investigated attributes of courses unrelated to content. The 1,472 respondents from seven western and mid-western states indicated their attitudes toward mandatory attendance, tuition charges, associated costs, length of course, cancellation policies, reputation of instructor, offerings for auxiliaries, and other attributes of continuing education programs. The findings suggest the need for changes in program management and for further research into factors unrelated to course content that influence demand for dental continuing education courses.

Major neurological events following foam sclerotherapy.

AIM: This report describes two complications of severe neurologic alterations (TIA, CVA) after foamed sclerotherapy injection. METHODS: Using foam sclerotherapy in accepted concentrations, volume, and in standard ratio of air to sclerosant, two serious neurologic complications occurred. RESULTS: In both cases described, unknown atrial communications existed resulting in foam emboli. One case involving the vertebral system resolved without treatment. The other involving the cerebral system was treated with hyperbaric oxygen. CONCLUSIONS: Foam sclerotherapy can cause serious neurologic phenomenon even though the incidence is rarely described. Immediate treatment with 100% O2 and possible hyperbaric O2 therapy should be considered.

Treatment of perforations of the esophagus associated with stricture.

Most strictures associated with perforation of the esophagus are anatomically suitable for this repair. The merit of this procedure is threefold: first, a two layer closure of the perforation is obtained; second, the stricture is obliterated, and third, the underlying cause of the disease--reflux--is adequately addressed.