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1.
Angiol Sosud Khir ; 25(3): 79-87, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31503250

RESUMO

BACKGROUND: Using assessment scales in clinical and research practice is one of fundamental reference methods of evaluation in human pathological states. Pelvic vein varicosity is an independent nosological entity within the framework of chronic vein diseases. Currently, the clinical methods of assessment in the aspect of a patient-oriented approach in this type of disease are largely understudied and still not duly defined. AIM: The study was aimed at analyzing clinical outcomes of surgical treatment in the form of resection of the ovarian vein in female patients with pelvic varicose veins, based on the developed specialized scale of clinical assessment of disease severity. PATIENTS AND METHODS: We carried out an open prospective study of efficacy of resection of the ovarian vein in 37 women with pelvic varicose veins. The main criterion for assessment was a clinical method of determining manifestations of the disease by means of the Pelvic Venous Clinical Severity Score. RESULTS: According to the Pelvic Venous Clinical Severity Score, improvement of the condition was observed in 36 (97.3%) operated female patients and 1 (2.7%) woman turned out to have negative dynamics. The median of the composite score of the severity scale decreased form 11.78±5.06 points to 5.22±3.19 (p<0.05). The total positive gradient of the score amounted to 6.57±3 .65 points. A significant decrease in manifestations of severity was observed for 9 of the 10 clinical descriptors of the disease. CONCLUSION: The use of the suggested scale in practical assessment of the results made it possible to prove high efficacy of resection of the ovarian vein in women with pelvic varicose veins in the form of decreased intensity of the disease's symptomatology. The VCSS is an easy-to-fill-in tool, taking up little time, ensuring no influence of the physician's personality on the answers, presenting quantitative expression of therapeutic results.


Assuntos
Pelve , Varizes , Insuficiência Venosa , Feminino , Humanos , Pelve/irrigação sanguínea , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Varizes/diagnóstico , Veias , Insuficiência Venosa/diagnóstico
2.
Pan Afr Med J ; 32: 147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303918

RESUMO

Orbital varix (or varicose) is an exceptional pathology with poor clinical sign. The blepharospasm can be a revealing cause. The long-term risk is optic atrophy and blindness. Magnetic resonance imaging is the best diagnostic tools. The rise of lesion dimensions by Valsalva maneuvers and prone position is characteristic. We report the observation of a 42-year-old young man, consulting for a blepharospasm of the left eye evolving for two years. Imaging investigations made the diagnosis of orbital varicose.


Assuntos
Blefarospasmo/etiologia , Órbita/irrigação sanguínea , Doenças Orbitárias/diagnóstico , Varizes/diagnóstico , Adulto , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Doenças Orbitárias/complicações , Varizes/complicações
4.
PLoS One ; 14(4): e0213834, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30939134

RESUMO

OBJECTIVES: Pelvic congestion syndrome is defined as chronic pelvic pain due to incompetent (dilated and refluxing) pelvic veins. The aim of this study was to investigate the prevalence of this condition by examining the prevalence of dilated ovarian and para-uterine veins in pre- and postmenopausal female patients, irrespective of their symptoms. We subsequently investigated how many women with dilated veins suffered from chronic pelvic pain. Additionally, we attempted to define diagnostic criteria that may allow for early identification of affected patients. METHODS: We reassessed 2384 abdomino-pelvic computed tomography scans performed on women at our institution. The maximal diameters of the ovarian and para-uterine veins were measured. Patients with a pathological process in the abdomen or pelvis affecting the veins were excluded. We considered ovarian vein dilation to be 6 mm or more in the axial plane. For patients that met these criteria, we performed a retrospective chart review to evaluate the clinical presentation and/or symptoms of these patients. RESULTS: Dilated pelvic veins were present in 293/2384 (12%) patients, 118/559 premenopausal (21%) and 175/1825 postmenopausal (10%). Chronic pelvic pain of unclear etiology had been documented prior to the CT in 54/293 (18%) women with dilated veins-2% of the whole study collective (54/2384); 8% of all premenopausal (44/559) and 0.5% of all postmenopausal (10/1825). It was often accompanied by urological symptoms such as hematuria, dysuria, and urinary frequency, in the absence of infection (p<0.05). We identified a strong correlation between the presence of dilated ovarian veins and chronic pelvic pain in premenopausal parous patients with hematuria. CONCLUSIONS: Pelvic congestion syndrome appears to be an underdiagnosed and undertreated disease. In our study, 8% of all premenopausal women had documented chronic pelvic pain of unclear etiology and dilated ovarian and pelvic veins on cross-sectional imaging studies. The features we identified in this study as most relevant should enable a faster identification of patients who could benefit from a specific treatment regimen for this condition.


Assuntos
Dor Crônica/etiologia , Ovário/irrigação sanguínea , Dor Pélvica/etiologia , Pelve/irrigação sanguínea , Varizes/diagnóstico , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Ovário/diagnóstico por imagem , Pelve/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Varizes/complicações , Veias/diagnóstico por imagem
6.
J Vasc Interv Radiol ; 30(6): 781-789, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30857986

RESUMO

Pelvic venous disorders (PeVDs) in women can present with chronic pelvic pain, lower-extremity and vulvar varicosities, lower-extremity swelling and pain, and left-flank pain and hematuria. Multiple evidence gaps exist related to PeVDs with the consequence that nonvascular specialists rarely consider the diagnosis. Recognizing this, the Society of Interventional Radiology Foundation funded a Research Consensus Panel to prioritize a research agenda to address these gaps. This paper presents the proceedings and recommendations from that Panel.


Assuntos
Pesquisa Biomédica , Dor Crônica , Ginecologia , Extremidade Inferior/irrigação sanguínea , Dor Pélvica , Pelve/irrigação sanguínea , Varizes , Vulva/irrigação sanguínea , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/terapia , Consenso , Feminino , Humanos , Dor Pélvica/diagnóstico , Dor Pélvica/fisiopatologia , Dor Pélvica/terapia , Valor Preditivo dos Testes , Prognóstico , Fluxo Sanguíneo Regional , Varizes/diagnóstico , Varizes/fisiopatologia , Varizes/terapia
7.
J Obstet Gynaecol Res ; 45(6): 1197-1200, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30884023

RESUMO

Spontaneous hemoperitoneum in pregnancy (SHiP), an unprovoked, non-traumatic intraperitoneal bleed in pregnancy and up to 42 days postpartum, is a rare but potentially life-threatening clinical condition. Here, we report a rare case of spontaneous rupture of uterine surface variceal vessels in the second trimester of pregnancy mimicking acute appendicitis that posed diagnostic difficulties and challenges in management.


Assuntos
Apendicite/diagnóstico , Hemoperitônio/diagnóstico , Ruptura Espontânea/diagnóstico , Útero/irrigação sanguínea , Varizes/diagnóstico , Adulto , Feminino , Humanos , Gravidez , Complicações na Gravidez
8.
Indian J Ophthalmol ; 67(3): 350-357, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30777952

RESUMO

Purpose: The purpose of this study is to describe the clinical characteristics, multimodality imaging findings, and clinical course of iris varices. Methods: Retrospective, noncomparative, observational case series of 28 eyes of 26 patients with iris varices, diagnosed between 2007 and 2017, has been used. Results: The mean (±SD) age was 58.3 ± 12.5 years (median 57.5, range 37-81). Patients were 57.7% male and 27% hypertensive. Varices were bilateral in two patients. The mean and median visual acuities were both 20/20 (range 20/16-20/40). Intraocular pressures were 16 mmHg (10-23 mmHg). Secondary glaucoma did not occur. The inferotemporal iris quadrant was affected in 75%. A single varix was seen in 64% and 36% appeared multiple. Varix orientation was radial in 57% and circumferential in 21%. Combined radial and circumferential varix orientation was noted in 18%. One had independent radial and circumferential varices in separate quadrants. A single episcleral sentinel blood vessel directed to the varix was present in 36%. Ultrasound biomicroscopy (UBM) showed a slightly increased mean iris thickness of 0.8 mm and multiple echolucent iris stromal vascular channels. Iris angiography showed no leakage of dye. Managed by observation over a mean follow-up of 37.7 months (range, 3-129), 96.4% eyes were stable and one (3.6%) regressed. No corectopia, ectropion uveae, hyphema, or metachronous anterior segment benign or malignant tumors occurred. Conclusion: Iris varix is primarily located in the inferotemporal quadrant and not associated with dysmorphic pupillary findings, progression, secondary glaucoma, or malignancy. Iris varices were benign vasculopathies with no associated ocular or vision-related morbidity.


Assuntos
Previsões , Pressão Intraocular/fisiologia , Doenças da Íris/diagnóstico , Iris/irrigação sanguínea , Varizes/diagnóstico , Acuidade Visual , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Humanos , Iris/diagnóstico por imagem , Doenças da Íris/fisiopatologia , Masculino , Microscopia Acústica , Pessoa de Meia-Idade , Estudos Retrospectivos
9.
Clin Exp Dermatol ; 44(5): e193-e195, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30687958

RESUMO

Accurate diagnosis and recognition of predisposing factors has been shown to be challenging in lower limb cellulitis (LLC). Assessment of 1746 consecutive patients with cellulitis presenting to a UK university hospital showed increasing overdiagnosis, with only 31.9% of patients referred during the period 2015-2018 having the diagnosis of LLC confirmed. Recognition of at least one predisposing factor increased from 61% to 89% following introduction of more specific screening questions. This identified a need for better primary care dermatology education and the benefit of a proforma with specific screening questions for reversible predisposing factors for LLC.


Assuntos
Celulite (Flegmão)/diagnóstico , Erros de Diagnóstico , Eczema/diagnóstico , Edema/diagnóstico , Dermatoses da Perna/diagnóstico , Linfedema/diagnóstico , Varizes/diagnóstico , Assistência Ambulatorial , Antibacterianos/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/epidemiologia , Doença Crônica , Edema/epidemiologia , Inglaterra , Hospitais Universitários , Humanos , Traumatismos da Perna/epidemiologia , Extremidade Inferior , Linfedema/epidemiologia , Encaminhamento e Consulta , Fatores de Risco , Inquéritos e Questionários , Tinha dos Pés/epidemiologia , Reino Unido
12.
Angiology ; 70(5): 388-396, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29874921

RESUMO

Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques that can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation, and each has its own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of nonthermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients.


Assuntos
Técnicas de Ablação , Cianoacrilatos/administração & dosagem , Embolização Terapêutica , Procedimentos Endovasculares , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Varizes/terapia , Técnicas de Ablação/efeitos adversos , Tomada de Decisão Clínica , Cianoacrilatos/efeitos adversos , Embolização Terapêutica/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Humanos , Seleção de Pacientes , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento , Varizes/diagnóstico , Varizes/fisiopatologia
13.
Int Angiol ; 37(6): 451-456, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30558403

RESUMO

BACKGROUND: The venous hypertension is suggested as the main cause of varicose disease. Some mediators and growth factors are known as the responsible of cellular events for the progression of venous perturbations. The aim of this study was to investigate non-coding (nc) RNA and MMP9 expression levels in macrophages differentiated from monocytes of patients with varicose veins. METHODS: The monocytes were isolated from the whole blood samples by RosetteSep kit and were differentiated to macrophages M2 using M-CSF factor. The based on ncRNA-gene network, lncRNA-GAS5, lncRNA-HOTAIR, miRNA-661, miRNA-1202, and MMP9 were selected. The gene expression levels were measured by RT-qPCR technique. RESULTS: Data showed that the MMP9 gene expression increased (P=0.003) while the GAS5, miRNA-661, and miRNA-1202 expression levels reduced significantly in the differentiated macrophages of patients (P=0.035, P=0.009, and P=0.015, respectively). Furthermore, the MMP9 gene expression levels were conversely related to the GAS5, HOTAIR, miRNA-661 and miRNA-1202 expression levels. CONCLUSIONS: The results suggested that the lncRNA-GAS5, miRNA-661, miRNA-1202 and MMP9 are involved in varicose disease.


Assuntos
Diferenciação Celular , Macrófagos/enzimologia , Metaloproteinase 9 da Matriz/genética , MicroRNAs/genética , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Varizes/enzimologia , Varizes/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Células Cultivadas , Feminino , Regulação Enzimológica da Expressão Gênica , Redes Reguladoras de Genes , Humanos , Masculino , Metaloproteinase 9 da Matriz/metabolismo , MicroRNAs/metabolismo , Pessoa de Meia-Idade , Fenótipo , Transdução de Sinais , Varizes/diagnóstico
14.
Angiol Sosud Khir ; 24(4): 81-87, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30531774

RESUMO

The purpose of this study was to assess the incidence of the development of symptoms of damage to subcutaneous nerves after endovenous laser coagulation (EVLC) of the great saphenous vein (GSV), as well as to determine the effect of these symptoms on quality of life (QoL) of patients. Our retrospective study enrolled a total of 119 patients (mean age 50±13.9 years) subjected to 151 isolated EVLC of the GSV. The average volume of the injected anaesthetic per 1 cm of the vein's length amounted to 8.5±1.9 ml. Puncture of the GSV at the level of the thigh was performed in 37 (24.5%) cases, at the level of the crus in 114 (75.5%) cases. The intervention was performed at the power 5-10 W and linear density of energy approximately 70 J/cm. The median of the follow up period amounted to 264 days. The patients were interrogated by phone. The questionnaire included leading, understandable for patients questions about the presence of postoperative complaints characteristic of damage to subcutaneous nerves, as well as the question about the effect of these complaints on quality of life. The complaints characteristic of damage to subcutaneous nerves were reported for 61 (40.4%) operated limbs, with these symptoms decreasing quality of life only in 7 (4.6%) cases. All respondents noted gradual regression of the symptoms with time. The median of symptom relief amounted to 2 months. The analysis of interrelationship between the level of puncture by the thirds of the femur and crus and the damage of subcutaneous nerves demonstrated no statistically significant association (p=0.108), unlike the analysis by the femur/crus level, wherein the infragenicular puncture significantly increased the risk of traumatisation of subcutaneous nerves (p=0.022). No statistically significant differences by the frequency of damage to subcutaneous nerves depending on the power of energy were revealed (p=0.662). The obtained findings make it possible to recommend EVLC, including with puncture of the GSV below the knee, for patients with varicose veins in this basin.


Assuntos
Procedimentos Endovasculares , Fotocoagulação a Laser , Traumatismos dos Nervos Periféricos , Complicações Pós-Operatórias , Qualidade de Vida , Veia Safena , Varizes , Adulto , Idoso , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Procedimentos Endovasculares/métodos , Humanos , Fotocoagulação a Laser/efeitos adversos , Fotocoagulação a Laser/métodos , Masculino , Pessoa de Meia-Idade , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/fisiopatologia , Traumatismos dos Nervos Periféricos/prevenção & controle , Traumatismos dos Nervos Periféricos/psicologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/psicologia , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Tela Subcutânea/inervação , Ultrassonografia Doppler Dupla/métodos , Varizes/diagnóstico , Varizes/psicologia , Varizes/cirurgia
15.
Angiol Sosud Khir ; 24(4): 90-94, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30531775

RESUMO

OBJECTIVE: The study was aimed at assessing the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux with the use of reference methods of examination. PATIENTS AND METHODS: We examines a total of 43 female patients (aged 41.5±5.2 years) presenting with pelvic varicose veins and subjected to phlebectomy on the external genitalia, perineum and lower limbs. All women had no evidence of pelvic venous plethora. All women underwent the following examinations: ultrasonographic angioscanning of pelvic and lower-limb veins, emission computed tomography of pelvic veins prior to operation, as well as 1, 6 and 12 months after surgical interventions. We evaluated efficacy of phlebectomy in elimination of pelvioperineal reflux and varicose syndrome, the frequency of detecting valvular insufficiency of pelvic and lower-limb veins, dynamics of the coefficient of pelvic congestion syndrome in the immediate and remote postoperative periods. RESULTS AND DISCUSSION: No cases of relapses of valvular, perineal varicosity, repeat appearance of varicose veins on the lower extremities, occurrence of signs of pelvic venous congestion were revealed. The frequency of detecting valvular insufficiency of the parametrial, uterine, gonadal and iliac veins remained unchanged. The coefficient of pelvic congestion syndrome did not alter either (Cpcs=0.8±0.11 at baseline versus Cpcs=0.78±0.1 after 12 months). CONCLUSION: The obtained results are indicative of a steady state of the venous outflow from the small pelvis in women with pelvic varicose veins and pelvioperineal reflux after surgical removal of vulvar, perineal and superficial femoral veins.


Assuntos
Embolização Terapêutica , Pelve Menor , Varizes/cirurgia , Procedimentos Cirúrgicos Vasculares , Insuficiência Venosa/cirurgia , Adulto , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/métodos , Feminino , Humanos , Pelve Menor/irrigação sanguínea , Pelve Menor/fisiopatologia , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional , Tomografia Computadorizada de Emissão/métodos , Resultado do Tratamento , Ultrassonografia Doppler Dupla/métodos , Varizes/diagnóstico , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Procedimentos Cirúrgicos Vasculares/métodos , Insuficiência Venosa/diagnóstico
18.
Angiol Sosud Khir ; 24(3): 92-97, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30321152

RESUMO

Compression serves as an important component for carrying out successful and safe phlebosclerosing treatment. At the same time, the necessity of wearing compression hosiery or bandages is associated with known limitations and objections of patients, especially in a hot season. We comparatively assessed efficacy of usual compression stockings and a short-term pneumatic bandage with cryoelements while carrying out sclerosing treatment of dilated intradermal veins. Our open prospective observational study included a total of fifty 18-to-35-year-old women. After performing standardized sclerotherapy of reticular veins and telangiectasias on the symmetrical portions of the lower limbs, a pneumatic cryocompression bandage with a pressure of 50 mmHg was applied onto one of the limbs for 15 minutes, with a class 2 compression (RAL standard) medical stocking put on the other limb to be worn by the patients at daytime for 10 days. We assessed completeness of obliteration of the target veins, frequency of the development of typical undesirable events (ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis), as well as the composite discomfort score according to an 11-point visual analogue scale. It was determined that using the pneumatic bandage with cryoelements as compared with the traditional compression stockings significantly decreased the frequency of the development of typical undesirable events after phlebosclerosing treatment, such as formation of ecchymoses, phlebitides, hyperpigmentation and neovasculogenesis. Significance of differences was revealed as early as 7 days after sclerotherapy, to be increasing during further dynamic follow up. By convenience for the patients, the use of the short-term pneumatic cryobandage was four times better than wearing the compression stockings. A conclusion was drawn that while carrying out sclerotherapy of reticular veins and telangiectasias short-term pneumatic cryocompression by efficacy and safety was not inferior to the traditional medical stockings (RAL standard) and made it possible to significantly decrease the incidence of the known undesirable events after phlebosclerosing treatment.


Assuntos
Crioterapia/métodos , Extremidade Inferior/irrigação sanguínea , Escleroterapia , Meias de Compressão , Telangiectasia/terapia , Varizes/terapia , Adulto , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Projetos Piloto , Escleroterapia/instrumentação , Escleroterapia/métodos , Telangiectasia/diagnóstico , Varizes/diagnóstico , Escala Visual Analógica
19.
Medicina (Kaunas) ; 54(5)2018 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-30344299

RESUMO

Jejunal varices are a rare manifestation of portal hypertension, and they are associated with a high mortality and poor prognosis when bleeding occurs. A bleeding jejunal varix is much more challenging to diagnose and manage because of its anatomic location. Herein, we describe the case of a 62-year-old man with active jejunal variceal bleeding who presented with massive hematochezia and hypovolemic shock. He was treated successfully with a high volume and concentration of a glue mixture as endoscopic sclerotherapy using single-balloon enteroscopy in the intensive care unit. Enteroscopic sclerotherapy is an effective option for jejunal variceal bleeding.


Assuntos
Cianoacrilatos/uso terapêutico , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Jejuno/irrigação sanguínea , Escleroterapia , Varizes/terapia , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/patologia , Endoscopia , Varizes Esofágicas e Gástricas/diagnóstico , Evolução Fatal , Hemorragia Gastrointestinal/diagnóstico , Humanos , Hipertensão Portal/complicações , Cirrose Hepática/complicações , Cirrose Hepática/patologia , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Enteroscopia de Balão Único , Varizes/diagnóstico
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