RESUMEN
The incidence of the post-thrombotic syndrome (PTS) is increasing along with the incidence of deep vein thrombosis (DVT). The overall frequency of PTS ranges from 20 percent to 50 percent of DVT patients; severe PTS, which includes leg ulcers, occurs in a quarter of cases. Because of its severity and chronicity, PTS is associated with great morbidity and cost. Its diagnosis is primarily based on the presence of typical symptoms and signs, but objective evidence of venous valvular reflux can help to confirm the diagnosis. Because therapeutic options for PTS are extremely limited and results are often disappointing, prevention, recognition of clinical signs or complications, and early treatment remain the keys to reducing its morbidity. The prevention of DVT recurrence by anticoagulation and use of graduated compression stockings is likely to reduce the risk of PTS. There is no proven role for thrombolysis in preventing PTS.
Asunto(s)
Síndrome Postrombótico , Piel/patología , Trombosis de la Vena/complicaciones , Anticoagulantes/uso terapéutico , Erisipela/etiología , Erisipela/patología , Humanos , Dermatosis de la Pierna/etiología , Dermatosis de la Pierna/patología , Linfangiosarcoma/etiología , Linfedema/etiología , Linfedema/patología , Síndrome Postrombótico/diagnóstico , Síndrome Postrombótico/etiología , Síndrome Postrombótico/prevención & control , Cuidados de la Piel , Neoplasias Cutáneas/etiología , Medias de Compresión , Trombosis de la Vena/terapiaRESUMEN
BACKGROUND: The literature on the benefit of alpha-interferon (IFN-alpha) as adjuvant postsurgical treatment of melanoma reports discordant results. OBJECTIVE: With the published data so far, we performed a meta-analysis in order to evaluate the effect of IFN-alpha on the relapse rate (RR) and the overall survival (OS). METHODS: Published randomised trials were identified by Medline search. Stage IV melanoma was not considered. RESULTS: Nine published studies were included, with a total of 2,880 patients. Both the per protocol and the intention-to-treat analysis show that IFN-alpha significantly decreased the RR (OR = 0.74; 95% CI = 0.64-0.86). Subgroup analyses show that, for all stages, high and low doses decreased the RR (OR = 0.71, 95% CI = 0.54-0.92, and OR = 0.76, 95% CI = 0.63-0.91, respectively). No difference has been evidenced on OS. CONCLUSIONS: High and low doses of IFN-alpha significantly decrease the RR, but the OS does not seem to be improved.
