RESUMO
AIM: Even though compression therapy is the most recommended treatment for chronic venous insufficiency (CVI) in the national and international guidelines, its application, at least in Italy, is lower than the estimated need from the prevalence of CVI in the epidemiological studies. Since we believe that the measurement of the impact of compression therapy on quality of life (QoL) could improve the compliance for this precious treatment, we carried out this study on 50 patients with CVI. METHODS: Fifty patients (23 CEAP C2 and 27 C(3-4-5), selected within a larger study on QoL in CVI), received a prescription for compression therapy. Before treatment and 4 months afterwards, the patients received the instrument for QoL assessment (MOS SF-36; CIVIQ-2; Euro-QoL 5D and a visual analogue scale). The score scales have been adjusted to poorest QoL as 0 and best QoL as 100. RESULTS: Baseline QoL of patients in class C2 did not show significant difference with the healthy Italian Population, except for the physical role item. The patients in class C(3-4-5) showed significant reduction of QoL. After 4 months all the items of the utilized instrument showed significant improvement (from P<0.01 to P<0.04 for SF-36; from P<0.099 to P<0.006 for other instruments) in all CEAP classes. CONCLUSIONS: The study unquestionably shows that the compression therapy improves the QoL of patients with CVI, and should be included in the CVI treatment covered by the Public National Health Insurance. Finally, the QoL measurement could be utilized as the scientific method to assess the effectiveness and efficacy of different therapeutic devices.
Assuntos
Bandagens , Qualidade de Vida , Insuficiência Venosa/terapia , Doença Crônica , Seguimentos , Humanos , Itália , Projetos Piloto , Prescrições , Inquéritos e Questionários , Resultado do Tratamento , Insuficiência Venosa/psicologiaRESUMO
BACKGROUND: Aortic dissection with rupture into the right atrium is an extremely rare condition and rapidly lethal. The authors report their experience in the treatment of two complicated aortic dissections observed at 85 and 93 months after previous cardiac operations. These were redo mitral valve replacement and saphenous vein coronary artery bypass grafts. METHODS: Both cases underwent hospital admission on an emergency basis because of severe chest pain and cardiac failure. One case had a history of hypertension. The aortography revealed aortic dissection and a fistulous communication into the right atrium. At surgery dissection repair and closure of the fistula was performed. Furthermore in one case vein grafts were reimplanted into the vascular graft. RESULTS: Both patients survived the operation without complications, were rapidly extubated and were asymptomatic and fully active at late follow-up. CONCLUSIONS: In the light of these results we conclude by affirming that aortic dissection with rupture into the right atrium is an extremely rare condition, rapidly lethal. Patient survival is strictly dependent on the time interval between fistulization of the dissection and the operation.
Assuntos
Aneurisma Aórtico/complicações , Dissecção Aórtica/complicações , Fístula/etiologia , Cardiopatias/etiologia , Idoso , Dissecção Aórtica/diagnóstico , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico , Aneurisma Aórtico/diagnóstico , Feminino , Fístula/diagnóstico , Átrios do Coração , Cardiopatias/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
An acute type A aortic dissection, complicated by massive aortic regurgitation, was diagnosed in the case of a 32-year-old woman, thirty-three days post partum. Emergency operation (Cabrol II) was performed with an uneventful postoperative course. We draw attention to this high risk event, which is particularly apt to involve women within a short time after an otherwise uneventful pregnancy.
Assuntos
Aneurisma Aórtico/complicações , Dissecção Aórtica/complicações , Insuficiência da Valva Aórtica/etiologia , Período Pós-Parto , Adulto , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/cirurgia , Aneurisma Aórtico/diagnóstico , Aneurisma Aórtico/cirurgia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/cirurgia , Aortografia , Ecocardiografia , Feminino , Seguimentos , HumanosRESUMO
We studied 30 patients (age range 58 to 64 years) who underwent vascular surgery for peripheral vascular disease (24 patients) and for carotid stenosis (6 patients). At the time of the study, all subjects have been taking antiplatelet agents for at least three months. They were divided into three groups of ten patients each: the first group received buflomedil (BUF), the second dipyridamole (DIP) and the third indobufene (IND), as treatment before vascular surgery. We investigated the influence of these drugs on hemorrheologic (hematocrit, whole blood and plasma viscosity) and blood coagulation (partial thromboplastin time, prothrombin time and bleeding time) parameters in all patients. In our experience, none of the three drugs influenced any tested parameters, which were within normal limits: among them we noted only a statistically significant difference in bleeding time between patients treated with BUF and IND.