[Clarithromycin consumption at the University Hospital of Liege in 2019. Retrospective study]. / Consommation de la clarithromycine au CHU de Liège en 2019. Etude rétrospective.

Macrolides are one of the treatments of choice in community-acquired pneumonia, either when the clinical and/or biological elements suggest an infection by an intracellular bacteria (so-called atypical), or when the severity of the clinical picture justifies their empirical use. This work is a retrospective monocentric study carried out at the University Hospital of Liege on 25 consecutive patients hospitalized during the year 2019. It aims to specify whether the use of a particular macrolide, clarithromycin, actually meets the national recommendations both in terms of indication, dosage or duration. The results showed justified and adequate use in only 44 % of cases. Nevertheless, the indication was overwhelmingly mentioned in the medical record (96 %). Furthermore, the comparison with national data showed a much higher than average use at the University Hospital of Liege. An action plan is suggested to discuss these results within the Antibiotic Therapy Management Group and then communicate them to the prescribers who are concerned. The aim is to adapt the use of macrolides at the University Hospital of Liege to be more in line with national recommendations.

Les macrolides sont un des traitements de choix dans les pneumopathies communautaires, soit lorsque les éléments cliniques et/ou biologiques suggèrent une infection par une bactérie intracellulaire (dite atypique), soit lorsque la sévérité du tableau clinique justifie d'emblée leur usage empirique. Ce travail est une étude rétrospective monocentrique réalisée au CHU de Liège sur 25 dossiers consécutifs de patients hospitalisés durant l'année 2019. Il vise à préciser si l'usage d'un macrolide particulier, la clarithromycine, répond effectivement aux recommandations nationales, tant en matière d'indication, de posologie ou de durée. Les résultats ont montré un usage justifié et adéquat dans 44 % des cas seulement. Néanmoins, l'indication était très majoritairement mentionnée dans le dossier médical (96 %). Par ailleurs, la comparaison avec les données nationales a montré un usage bien supérieur à la moyenne au CHU de Liège. Un plan d'action est suggéré afin de discuter ces résultats au sein du Groupe de Gestion de l'Antibiothérapie pour, ensuite, les communiquer aux prescripteurs concernés. Cette stratégie est proposée afin d'adapter l'usage des macrolides au CHU de Liège pour qu'il s'accorde davantage avec les recommandations nationales.

Nutritional status and anxious and depressive symptoms in anorexia nervosa: a prospective study.

The interweaving of malnutrition and symptoms of anxiety and depression in anorexia Nervosa (AN) is mentioned without any consensus regarding the course of anxious-depressive symptoms in relation to nutritional status in the course of treatment of patients with AN. The objectives of the current study in a large sample of AN inpatients were to assess the relationships between anxiety and depression symptoms and nutritional status both over the course of inpatient treatment and at discharge. 222 consecutive inpatients with AN (DSM-IV TR) were assessed (entrance and discharge) for duration of illness, psychiatric treatments, sociodemographic data and with psychometric scales for different psychopathological symptoms [depressive (BDI), anxiety and depressive (HAD scale), obsessive-compulsive (MOCI) and social phobia (LSAS fear score)]. Nutritional status was assessed with Body Mass Index (BMI) and body composition by bioelectrical impedance. The Fat free mass index [FFMI = FFM (kg)/height (m2)] was considered for the analysis. Two models were developed where the dependent variables were each psychopathological score at discharge (BDI, HAD anxiety, MOCI, and LSAS fear) in the cross-sectional model, and their variation in the longitudinal model (where a positive score reflected symptom decrease at discharge). A fixed set of predictors, defined on presumed clinical and statistical relevance (FFMI in the cross-sectional model and Variation of FFMI in the longitudinal model), were considered in each model, without any model selection procedure. This is the first study to confirm a positive relationship between the course of eating disorder symptoms and that of anxious-depressive symptoms during inpatient treatment of AN even after adjustment on a vast array of possibly confounding factors.

Intra-operative methadone effect on quality of recovery compared with morphine following laparoscopic gastroplasty: a randomised controlled trial.

The effect of intra-operative intravenous methadone on quality of postoperative recovery was compared with morphine after laparoscopic gastroplasty. We included 137 adult patients with a body mass index > 35 kg.m-2 who underwent bariatric surgery. Patients were allocated at random to receive either intra-operative methadone (n = 69) or morphine (n = 68). All patients received the same postoperative care and analgesia. The primary outcome of postoperative quality of recovery was assessed using the Quality of Recovery-40 questionnaire total score 24 h after surgery. Secondary outcomes were assessed in the post-anaesthesia care unit the night of the day of surgery (T1), in the morning after surgery (T2); and at night on the day following surgery (T3). The median (IQR [range]) total Quality of Recovery-40 questionnaire score of 194 (190-197 [165-200]) was higher (p < 0.0001) in the methadone group compared with the score of 181 (174-185.5 [121-200]) in the morphine group. In the post-anaesthesia care unit, the pain burden; incidence of nausea and vomiting; rescue morphine dose; and time to discharge, were significantly lower in the methadone group. On the ward, the methadone group had a lower: incidence of rescue morphine requests at T1 (5.8 vs. 54.4%, p < 0.0001) and T2 (0 vs. 20.1%, p < 0.0001); and incidence of nausea (21.7 vs. 41.2%, p = 0.014), compared with the morphine group. We conclude that intra-operative intravenous methadone improved quality of recovery in patients who underwent laparoscopic gastroplasty, compared with intra-operative morphine. Methadone also reduced postoperative pain, postoperative opioid consumption and the incidence of opioid-related adverse events.

Movie violence acutely affects food choices in young adults.

BACKGROUND: Extensive research has been conducted to investigate the effects of media violence on attitudes, behaviors, and cardiovascular health; however, only few studies have examined its effect on appetite, eating behavior and food preferences. Little attention has been given to understand how movie genre manipulates the physiology and the eating behavior of individuals. The present study aimed at investigating the acute effect of violence content in movies on appetite perception, heart rate and blood pressure, along with food preferences and intake in young individuals. METHODS: Participants (n = 84) were randomly assigned to either watch a violent movie or a non-violent narrative movie. Measurements including anthropometry, heart rate, blood pressure and grip strength were taken and appetite as well as stress perception were assessed. Subjects were then provided with an individual snack tray containing various items to be consumed ad libitum. RESULTS: Post intervention, the experimental group (EG) had a higher consumption of fatty (t (82) = 2.28, p = 0.025, d = 1.52) and salty (t (82) = 2.61, p = 0.01, d = 0.71) food items compared to the control group (CG). Out of the 42 participants in the EG 62% consumed >2 fatty items and 71.4% consumed >2 salty food items. No significant difference in the consumption of sugary items was observed between the two groups. CONCLUSION: Movie violence affects eating behavior and may promote weight gain.

Effect of movie violence on mood, stress, appetite perception and food preferences in a random population.

Very little is known about media violence and its effect on appetite and eating behavior. The present study aims at investigating the immediate acute effect of violence in movies on mood, stress, appetite perception and food preferences in a real-life setting. A total of 447 subjects (F = 202; M = 239) completed a validated visual analog scale to record their subjective feelings of hunger, satiety and desire to eat immediately at their way out of any of the three types of movies (horror, romance/comedy and drama/action). There was a significant difference between the three movie categories for the tensed feeling (P = 0.003), anxiety (P = 0.021), the sleepy feeling (P = 0.000) and a preference to eat something sweet (P = 0.019). Horror/violence movie types affected the subject by making him feel more stressed and anxious; however, romance made him feel sleepier and less tensed. Movie types did not seem to affect hunger or appetite directly, but rather triggered some food preferences.

Can birth weight predict later body composition in anorexia nervosa?

BACKGROUND/OBJECTIVES: The relationship between birth weight and body composition at later stages in life was not studied previously in anorexia nervosa (AN). The aim of the following brief report is to present results concerning the relationship between birth weight and later body composition specifically in AN, and to check if the programming of body composition from birth weight is still detected in severely emaciated AN patients. SUBJECTS/METHODS: One hundred and fifty-one female AN patients aged between 13 and 44 were recruited from 11 inpatient treatment facilities in France. Birth weight, body weight and height were obtained. Body composition was measured using bioelectrical impedance. Birth weight was significantly correlated to lifetime maximum body mass index (BMI; r=0.211, P=0.009) and significantly correlated to fat-free mass index (r=0.190, P=0.027) but not to fat mass index (FMI). RESULTS: This report confirms that even in AN when patients are severely emaciated and where fat-free mass (FFM) and fat mass (FM) are low, a link between birth weight and FFM and BMI can still be identified, independently from age. CONCLUSION: Further studies are needed on larger samples exploring other factors, such as gender, puberty and ethnicity.

Glutaraldehyde-treated homologous vein graft as a vein substitute: experimental study in rabbits.

AIM: Vein reconstruction using grafts may prevent sequelae of venous interruption or lesion. Autologous vein is sometimes unsuitable or absent for a vascular restoration. The aim of this study was to study glutaraldehyde-treated homologous vein graft as vein substitute and compare it with autologous vein as a substitute for a vena cava segment in rabbits. METHODS: Sixty rabbits were allocated into two groups: autologous vein graft (AG), and glutaraldehyde-treated homologous vein graft (HG). Each group was subdivided into three subgroups (N.=10) to be studied at: 24 hours, 14 days, and 28 days. The veins were treated in 0.19% glutaraldehyde, pH=7.4, for 1 hour and kept at 4 degrees C in saline with added gentamicin and amphotericin B. The animals received benzanthine penicillin on the day of graft implantation and heparin only during surgery. The grafts were implanted into the vena cava. Anastomosis was performed with interrupted sutures. Cavography was performed, after surgery, and at the time the animals were killed. Evaluation of the veins was made macroscopically and by light and scanning electron microscopy. RESULTS: Fibrosis was seen around the grafts at 14 and 28 days, with no difference in intensity between the groups. Cavography performed before euthanasia of the animals showed 4 partial thrombi in AG (2 at 24 hours and 2 at 14 days), 3 in HG (2 at 24 hours and 1 on day 14), and 4 occlusive thombi in HG (3 at 14 days and 1 at 28 days). Macroscopic examination did not show any thrombus in AG. In HG, two partial thrombi were confirmed at 24 hours and three occlusive thrombi at 14 days. There was no statistical difference in relation to patency between the two groups. At 14 and 28 days, the histological sections showed intimal hyperplasia of similar intensity and variable distribution in both groups. Evaluation by electron microscopy showed at 24 hours lesion areas characterized by absence of the endothelium on the graft surface, presence of inflammatory cells, and, at some sites, presence of mural thrombi in AG and HG. Both groups at 14 and 28 days showed endothelial cells covering the lesion area on the graft surface, this covering being larger in AG than in HG. CONCLUSIONS: In the studied model, both grafts behaved similarly in relation to patency and morphological characteristics. This suggests that the glutaraldehyde-treated graft can be a promising alternative for vein reconstruction, justifying further animal studies with the aim of using it in human surgery.

Insufficient flow reduction during LBNP in both splanchnic and lower limb areas is associated with orthostatic intolerance after bedrest.

We quantified the impact of a 60-day head-down tilt bed rest (HDBR) with countermeasures on the arterial response to supine lower body negative pressure (LBNP). Twenty-four women [8 control (Con), 8 exercise + LBNP (Ex-LBNP), and 8 nutrition (Nut) subjects] were studied during LBNP (0 to -45 mmHg) before (pre) and on HDBR day 55 (HDBR-55). Left ventricle diastolic volume (LVDV) and mass, flow velocities in the middle cerebral artery (MCA flow) and femoral artery (femoral flow), portal vein cross-sectional area (portal flow), and lower limb resistance (femoral resistance index) were measured. Muscle sympathetic nerve activity (MSNA) was measured in the fibular nerve. Subjects were identified as finishers or nonfinishers of the 10-min post-HDBR tilt test. At HDBR-55, LVDV, mass, and portal flow were decreased from pre-HDBR (P < 0.05) in the Con and Nut groups only. During LBNP at HDBR-55, femoral and portal flow decreased less, whereas leg MSNA increased similarly, compared with pre-HDBR in the Con, Nut, and NF groups; 11 of 13 nonfinishers showed smaller LBNP-induced reductions in both femoral and portal flow (less vasoconstriction), whereas 10 of 11 finishers maintained vasoconstriction in either one or both regions. The relative distribution of blood flow in the cerebral versus portal and femoral beds during LBNP [MCA flow/(femoral + portal flow)] increased or reduced < 15% from pre-HDBR in 10 of 11 finishers but decreased > 15% from pre-HDBR in 11 of 13 nonfinishers. Abnormal vasoconstriction in both the portal and femoral vascular areas was associated with orthostatic intolerance. The vascular deconditioning was partially prevented by Ex-LBNP.

WISE-2005: tibial and gastrocnemius vein and calf tissue response to LBNP after a 60-day bed rest with and without countermeasures.

The objective of this study was to quantify by echography the changes in the intramuscular [gastrocnemius (Gast)] and nonintramuscular [posterior tibial (Tib)] calf veins cross-sectional area (CSA) and the superficial tissue thickness (STth) in response to lower body negative pressure (LBNP) after 60-day head-down bed rest (HDBR). Twenty-four healthy women (25-40 yr) were divided into three groups: control (Con), treadmill-LBNP and flywheel (Ex-Lb), nutrition (Nut; protein supplement). All underwent a LBNP (0 and -45 mmHg) before and on day 55 of HDBR. Subjects were identified as finisher (F) or nonfinisher (NF) of a 10-min tilt test after 60 days of HDBR. There were no differences in resting CSA of the Tib and Gast veins on HDBR day 55 compared with pre-HDBR for the Ex-Lb, Con and Nut, or the F groups; however, for NF both the Tib and Gast vein CSA at rest were significantly smaller after HDBR. At -45 mmHg LBNP, Tib and Gast CSAs were not significantly different from before HDBR in all groups (Ex-Lb, Con, Nut, F, NF). However, percent change in CSA of both veins from rest to -45 mmHg LBNP was significantly greater in the Con and Nut groups compared with Ex-Lb, and also NF compared with F. Similarly, the percent increase in STth on going from rest to -45 mmHg was higher after HDBR in the Con and Nut groups compared with Ex-Lb, as well as NF compared with F. These results showed that the Ex-Lb countermeasure minimized the bed rest effect on leg vein capacitance (CSA percent change) and STth increase during LBNP, whereas Nut had no effect and that higher leg vein and superficial tissue capacitance were associated with reduced orthostatic tolerance.

WISE 2005: stroke volume changes contribute to the pressor response during ischemic handgrip exercise in women.

The mechanism of the pressor response to small muscle mass (e.g., forearm) exercise and during metaboreflex activation may include elevations in cardiac output (Q) or total peripheral resistance (TPR). Increases in Q must be supported by reductions in visceral venous volume to sustain venous return as heart rate (HR) increases. Therefore, this study tested the hypothesis that increases in Q, supported by reductions in splanchnic volume (portal vein constriction), explain the pressor response during handgrip exercise and metaboreflex activation. Seventeen healthy women performed 2 min of static ischemic handgrip exercise and 2 min of postexercise circulatory occlusion (PECO) while HR, stroke volume and superficial femoral artery flow (Doppler), blood pressure (Finometer), portal vein diameter (ultrasound imaging), and muscle sympathetic nerve activity (MSNA; microneurography) were measured followed by the calculation of Q, TPR, and leg vascular resistance (LVR). Compared with baseline, mean arterial blood pressure (MAP) (P < 0.001) and Q (P < 0.001) both increased in each minute of exercise accompanied by a approximately 5% reduction in portal vein diameter (P < 0.05). MAP remained elevated during PECO, whereas Q decreased below exercise levels. MSNA was elevated above baseline during the second minute of exercise and through the PECO period (P < 0.05). Neither TPR nor LVR was changed from baseline during exercise and PECO. The data indicate that the majority of the blood pressure response to isometric handgrip exercise in women was due to mobilization of central blood volume and elevated stroke volume and Q rather than elevations in TVR or LVR resistance.

WISE 2005: vascular responses to 60-day bed rest in women.

WISE-2005 studied 24 women during a 60-day head down bed rest (HDBR) who look part in an exercise countermeasure (LBNP-treadmill plus flywheel, EX) and no-exercise (No-EX). We conducted a series of experiments to explore changes in cardiovascular function and the ability of EX to prevent these changes. Resting arterial diameter in the arm was not affected but the leg arteries (femoral and popliteal) were significantly reduced in Np-EX, but was increased in EX. In this study we report on drug stimulated responses with sublingual nitroglycerin and infused isoproterenol. Heart rate increased in response to nitroglycerin with larger increases in No-EX after HDBR. Likewise during isoproterenol infusion the HR increase was greater after HDBR in the No-EX group. In all cases, the higher HR was associated with lower stroke volume in No-EX while stroke volume was protected in EX. These data do not support a change in sensitivity of beta-adrenergic receptors after HDBR. The leg vascular resistance decreased in response to isoproterenol and it decreased to a greater extent in No-EX than EX. These data were consistent with observations of lower leg vascular resistance during orthostatic challenge tests after HDBR. We conclude that consistent changes in cardiovascular function in the No-EX were detected by different methods that point to mechanisms contributing to orthostatic intolerance after HDBR.

Effect of diclofenac sodium on the healing process of end-to-end anastomosis in carotid arteries of rabbits. Histopathological and biomechanical studies.

AIM: Diclofenac sodium is a non-steroidal anti-inflammatory drug commonly used to attenuate painful inflammatory reactions in surgery. However, it may delay healing in the skin and gastrointestinal tract. The aim of this study was to evaluate the influence of Diclofenac in vascular healing. METHODS: Ninety rabbits had their carotid arteries sectioned and reconstructed by end-to-end anastomosis with interrupted sutures. The animals were randomly allocated into 3 groups of 30 each and treated by intramuscular route with saline (control), 5 mg/kg/day of diclofenac sodium (DS-5), and 10 mg/kg/day of diclofenac sodium (DS-10). Treatment began on the day of surgery and lasted 4 days. Angiography, biomechanical properties (failure load, failure elongation, yield point, yield point elongation, and stiffness were obtained from the load/elongation curve), macroscopic and histological examinations (hematoxylin-eosin, Masson, Calleja, Picrossirius-red), and scanning electron microscopy were studied in both arteries on the 3rd and 15th postoperative days. RESULTS: No significant differences in biomechanical properties were observed either in the 3 groups or the experimental times. The carotid artery healing process was similar in the 3 groups. CONCLUSION: Diclofenac sodium did not cause alterations nor delayed carotid artery healing.

Antithrombotic effect of Lonomia obliqua caterpillar bristle extract on experimental venous thrombosis.

The venom of Lonomia obliqua caterpillar may induce a hemorrhagic syndrome in humans, and blood incoagulability by afibrinogenemia when intravenously injected in laboratory animals. The possible antithrombotic and thrombolytic activities of L. obliqua caterpillar bristle extract (LOCBE) were evaluated in this study. The minimal intravenous dose of the extract necessary to induce afibrinogenemia and anticoagulation was 3.0 and 10.0 microg protein/kg body weight for rabbits and rats, respectively. In rabbits, this dose induced total blood incoagulability for at least 10 h and did not reduce the weight of preformed venous thrombi, in contrast to streptokinase (30,000 IU/kg). In rats, pretreatment with 5.0 and 10.0 microg/kg LOCBE prevented the formation of thrombi induced by venous stasis or by injury to the venous endothelium. The dose of 5.0 microg/kg LOCBE did not modify blood coagulation assay parameters but increased bleeding time and decreased plasma factor XIII concentration. When the extract was administered to rats at the dose of 10.0 microg/kg, the blood was totally incoagulable for 6 h. These data show that LOCBE was effective in preventing experimental venous thrombosis in rats, justifying further studies using purified fractions of the extract to clarify the mechanisms of this effect.

Antithrombotic effect of Lonomia obliqua caterpillar bristle extract on experimental venous thrombosis

The venom of Lonomia obliqua caterpillar may induce a hemorrhagic syndrome in humans, and blood incoagulability by afibrinogenemia when intravenously injected in laboratory animals. The possible antithrombotic and thrombolytic activities of L. obliqua caterpillar bristle extract (LOCBE) were evaluated in this study. The minimal intravenous dose of the extract necessary to induce afibrinogenemia and anticoagulation was 3.0 and 10.0 æg protein/kg body weight for rabbits and rats, respectively. In rabbits, this dose induced total blood incoagulability for at least 10 h and did not reduce the weight of preformed venous thrombi, in contrast to streptokinase (30,000 IU/kg). In rats, pretreatment with 5.0 and 10.0 æg/kg LOCBE prevented the formation of thrombi induced by venous stasis or by injury to the venous endothelium. The dose of 5.0 æg/kg LOCBE did not modify blood coagulation assay parameters but increased bleeding time and decreased plasma factor XIII concentration. When the extract was administered to rats at the dose of 10.0 æg/kg, the blood was totally incoagulable for 6 h. These data show that LOCBE was effective in preventing experimental venous thrombosis in rats, justifying further studies using purified fractions of the extract to clarify the mechanisms of this effect

Activities of counsellors in a hospice/palliative care environment.

This study examined activities related to the provision of psychosocial care by counsellors in the hospice/palliative care setting. A qualitative design using written reports was used in an urban Canadian hospice/palliative care program. A convenient sample of 13 counsellors indicated the activities they typically performed in their work with patients and families. Thematic analysis of the activities directly related to patient and family care was performed and then validated by presenting these activities back to the counsellors in a group setting. Seven themes resulted: 1) companioning; 2) psychosocial assessment, planning, and evaluation; 3) counselling interventions; 4) facilitation and advocacy; 5) patient and family education; 6) consultation and reporting; and 7) team support. These thematic findings confirmed those of previous studies and also highlighted two additional findings. Team support was seen as an activity that directly affected client care, and there was a strong emphasis on the activity of companioning the dying and their families. Also discussed are implications of these results, as well as suggestions for further research.

Effect of different glycosaminoglycans in a guinea-pig carotid artery thrombosis model.

Heparin is the most frequently used drug for the prevention and treatment of thrombosis. Its use, however, is restricted by its side-effects. To study the efficacy of other glycosaminoglycans that could substitute heparin in the management of arterial thrombosis, 60 guinea-pigs were randomly allocated into 6 groups: G1 = control, G2 = heparin (150 IU/kg), G3 = heparan sulfate from beef pancreas (2.5 mg/kg), G4 = heparan sulfate from beef lung (2.5 mg/kg), G5 = N-acetylated heparan from beef pancreas, G6 = dermatan sulfate from beef intestine (2.5 mg/kg). Ten minutes after intravenous injection of the drugs, thrombosis was induced by the injection of a 50% glucose solution into a segment of the right carotid artery isolated between 2 thread loops during 10 minutes. Three hours later the artery was re-exposed and if a thrombus was present it was measured, withdrawn and weighed. Thrombin time and activated partial thromboplastin time were measured in all animals. Thrombus developed in 90% of the animals in the control group, 0% in G2 and G3, 62.5% in G4, 87.5% in G5 and G6. Only in the animals treated with heparin the coagulation tests were prolonged. In conclusion, in the used dose only the heparan sulfate from beef pancreas presented an antithrombotic effect similar to heparin in this experimental model.

[Bullous pemphigoid and multiple sclerosis]. / Pemphigoïde bulleuse et sclérose en plaques.

The occurrence of bullous pemphigoid (BP) in patients with multiple sclerosis (MS) is uncommon. The aetiology is not clear and several abnormalities of the immune system are reported in both pathologies. We report one additional case in a 40-year-old woman with a 15-year history of MS. BP was confirmed histologically and immunologically. The therapy with steroids was successful and no recurrence of BP was observed after a six month follow-up.

Heparin, heparin plus ASA and dipyridamole, and arteriovenous fistula as adjuvant methods to prevent rethrombosis after venous thrombectomy. Experimental study in rabbits.

Venous rethrombosis following thrombectomy is a common event. The aim of the present study was to verify the action of heparin, heparin plus acetyl salicylic acid (ASA) and dipyridamole, and of an arteriovenous fistula (AVF) in the prevention of this complication. Thrombosis was induced in 48 male rabbits by the injection of thrombin in a segment of the left jugular vein, in which the blood flow was arrested for 10 minutes. After 48 hours, the animals were randomly allocated into one of 4 groups of treatment: (1) control, (2) subcutaneous heparin (600 S.I. Units/kg--8/8 hours), (3) heparin, in the same dose, plus ASA (10 mg/kg/once a day), and dipyridamole (0.5 mg/kg thrice a day), (4) an AVF was surgically constructed between the left carotid artery and the left maxillar vein. After 30 minutes, thrombectomy was performed. The venous blood flow, the hematocrit, activated partial thromboplastin time and thrombin time tests were performed before, right after the thrombectomy and 48 hours after thrombectomy. Venography was performed after thrombectomy and at the end of the experiment. The animals were killed 48 hours after thrombectomy and the veins were examined macroscopically. Venous rethrombosis was significantly prevented only in the AVF group (9/12), when compared to control group (0/12), heparin group (1/12) and heparin plus antiaggregating agents group (2/12). These results validate further clinical and experimental investigations with the use of AVF to prevent rethrombosis after venous thrombectomy, when a reduction of venous flow is present.