bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neutrophil CD11b Expression in Patients with Venous Disease
Authors: Shields D. A. , Saharay M. , Timothy-Antoine C. , Porter J. B. , Scurr J. H. , Smith P. D. Coleridge 
Published: January 2017

Objective: To determine whether neutrophil CD11b, a marker of neutrophil adhesion, differs in patients with varying degrees of severity of venous disease, and to compare the values obtained with those of age-matched normal control subjects. Design: Prospective study, measuring white cell count and neutrophil CD11b expression in whole blood using a fluorescent-labelled monoclonal antibody in a flow cytometer. Setting: The Middlesex Hospital Vascular Laboratory, a referral centre for the investigation of venous disease. Patients: Ten patients with uncomplicated varicose veins, 10 patients with skin changes of lipodermatosclerosis (LDS), and 20 age-matched control subjects with no history or clinical finding of venous disease. Results: Higher levels of CD11b were found in patients with uncomplicated varicose veins compared with their controls (median 4.6 cf. 1.43 for normal controls, P = 0.005, Mann-Whitney U-test, difference between medians 2.7, 95% confidence interval 1 to 4.6), and lower levels in patients with LDS (median 1.22 cf. 1.53 for normal controls, p = 0.028, Mann-Whitney U-test, difference between medians 0.45, 95% confidence interval 0.02 to 1.3). There was no difference in the white cell or neutrophil count between the patient and control groups. Conclusions: This study demonstrates increased neutrophil surface CD11b expression in patients with uncomplicated varicose veins, but decreased levels in patients with LDS. This might be due to up-regulation of CD11b in some neutrophils with subsequent adhesion, so that only those with low expression remained in the peripheral circulation. Alternatively, this might represent either down-regulation or chronic exhaustion of neutrophil CD11b in these patients.
Objective Quantification of the Continuous-Wave Venous Doppler Examination
Authors: Harward T. R. S. , Kraemer K. , Bernstein E. F. , Fronek A. 
Published: January 2017

Objective: To develop a quantitative, objective method to diagnose deep venous thrombosis (DVT) with the continuous-wave (CW) Doppler system. Design: Case control study. Setting: Vascular Laboratory of the Surgical Services, Veteran's Affairs Medical Center, La Jolla, California, USA. Patients, participants: Thirty-five control subjects and the limbs of 50 patients with suspected DVT were examined. Main outcome measures: Phlebography, CW Doppler ultrasound. CW Doppler output was recorded from the popliteal, superficial femoral and common femoral veins. The response to standardized calf compression was analysed. Results: The most useful information included the Doppler velocity increase, decay time and deceleration. Because the determination of decay time does not require calibration of the Doppler system, it is the preferred parameter. Conclusions: A decay time longer than 1.05 s is a very good discriminant between normal control and DVT limbs.
Sclerotherapy for Telangiectasis of the Leg: Results of a 5-Year Follow-up
Authors: Lucchi M. , Bilancini S. , Tucci S. 
Published: January 2017

Objective: To evaluate the recurrence of telangiectases in patients who had previously been treated by sclerotherapy. Design: Retrospective single patient group study with 5-year follow-up. Setting: Centra Studi Malattie Vascolari ‘J. F. Merlen’, Frosinone, Italy. Patients and methods: The records of 52 patients who had been treated by sclerotherapy for leg telangiectases 5 years earlier were reviewed. Patients had been reviewed at yearly intervals. The reappearance of telangiectases at the initial treatment site and at new sites had been recorded at each review. Results: In 77% of patients studied (40/52) new telangiectases appeared. Of these, 67% (35/72) were in a different area and 56% (29/52) were in the same area (χ2 = N.S.). In 46% of cases (24/52) telangiectases occurred both in the area treated originally and in additional areas. In 48% of cases affected by a recurrence (19/40), the additional telangiectases were of minimal extent requiring little if any treatment. Conclusions: Sclerotherapy of telangiectases treats the consequences of the disease and does not address the cause. Consequently, patients often suffer recurrence of their telangiectases. This may be regarded as an evolution of the disease, affecting new veins, rather than true recurrence. Maintenance treatment will often be required to sustain the results following the initial course of sclerotherapy.
A Double-Blind Clinical Trial of Hydroxyethylrutosides in the Treatment of the Symptoms and Signs of Chronic Venous Insufficiency
Authors: Cloarec M. , Clément R. , Griton P. 
Published: January 2017

Objective: To study the safety and efficacy of hydroxyethylrutosides (HR) in patients with chronic venous insufficiency (CVI) (Widmer grade II) and examine any correlation with objective measurements (plethysmography and Tc Po2). Design: Double-blind, randomized, placebo-controlled, multicentre trial. Setting: One outpatient university angiology clinic, one outpatient angiology clinic in a military hospital and one private angiological consultation, all in the Paris area. Patients: One hundred and nine patients with grade II Widmer CVI, confirmed by echo-Doppler and plethysmography. Elastic stockings were excluded. After five exclusions, 53 received HR and 51 placebo. Interventions: Patients randomized to one sachet of 1 g HR twice daily (or placebo) for 2 months, after a 1 month placebo run-in period. Examinations on entry to the trial (T–1), after 1 month run-in (T–0) and after 1 (T+1) and 2 months (T+2) treatment. Main outcome measures: These were measured at each of the four visits. Primary outcome: minimal ankle and maximal calf circumferences. Secondary outcomes: five individual leg symptoms and total symptom score, pitting oedema. Plethysmography (six calculated variables) and Tc Po2. Results: The reduction of both ankle and calf circumferences was significantly greater in the HR group ( p<0.0001), as was pitting oedema ( p<0.001), the five individual symptoms and the total symptom score ( p<0.001). Of the plethysmographic findings, there was a significant reduction in maximum venous outflow ( p<0.001 at T+1 and p<0.05 at T+2). Overall there was no significant change in Tc Po2. Conclusions: HR is an effective and well-tolerated treatment for leg oedema and symptoms of patients with CVI.
The Effect of Probe Position, Calf Muscle Function and Lipodermatosclerosis on Photoplethysmographic Venous Refilling Time
Authors: Rashid P. , Stacey M. C. , Hoskin S. E. , Pearce C. A. 
Published: January 2017

Objective: To assess the influence of probe position, lipodermatosclerosis and method of calf muscle emptying on the venous refilling time as measured by photoplethysmography in both normal limbs and limbs with chronic venous disease. Design: Prospective evaluation of age- and sex-matched control and study groups. Setting: University Department of Surgery, Vascular Research Laboratory, Fremantle Hospital, Western Australia. Patients: There were 38 controls and 31 patients with venous ulceration. Interventions: Venous refilling times were measured in six positions on the leg in all subjects: the foot, 5 cm below medial tibial condyle in the upper calf, and in the gaiter region on the medial, lateral, anterior and posterior positions at 7.5 cm above the medial malleolus. Measurements were undertaken on active exercise and after bimanual calf compression in the medial gaiter region. Measurements were also undertaken in areas of lipodermatosclerotic skin and in normal-appearing adjacent skin. Results: In normal legs, the lowest refilling times were in the anterior and lateral gaiter positions. Venous patients had a shorter refilling time in the dorsal foot, medial gaiter, posterior gaiter and medial below-knee positions, when compared with controls (Mann–Whitney U-test, p<0.01). The shortest refilling time in patients with venous disease was in the medial gaiter region. Refilling time was slightly prolonged over Hpodermatosclerotic skin compared with adjacent normal-looking skin. Refilling time measured after passive emptying of the calf muscle by external compression was significantly prolonged compared with calf emptying by active calf compression ( p<0.01). This change was similar for both groups. Conclusions: When using venous refilling time on photoplethysmography to distinguish venous from normal limbs, the best separation is in the medial gaiter position. If other probe sites or methods of calf emptying are to be employed, it is imperative that individual laboratory normal ranges be established for the particular method being employed.
The Effect of Graduated Compression Stockings on Lower Limb Venous Haemodynamics
Authors: Cooke E. A. , Benkö T. , O'Connell B. M. , McNally M. A. , Mollan R. A. B. 
Published: January 2017

Objectives: To compare the effect of four types of thigh-length graduated compression stockings (GCS) on lower limb venous blood flow using strain-gauge Plethysmography (SGP). Design: A randomized controlled study. Setting: Inpatient Orthopaedic Centre. Patients: 200 preoperative patients admitted for elective lower limb orthopaedic surgery. Interventions: Patients were randomized to five groups to wear one of four types of GCS or no stocking (control). Resting venous flow parameters were measured prior to application of GCS and after 20 min bed rest with the stockings in situ. Main outcome measures: Effects on resting venous capacitance (Vc) and venous outflow (Vo). Results: In the control group 20 min bed rest had no effect on the parameters studied. Both Vc and Vo were significantly increased ( p<0.001) in all the groups wearing stockings. There was a significant variation in the changes in outflow produced by the different stocking types ( p<0.05). Conclusions: GCS have a beneficial effect on lower limb venous outflow, preventing venous stasis, an important factor in the development of deep venous thrombosis. This effect varies depending on which type of stocking is used.
Laser Doppler Flux in Normal and Varicose Long Saphenous Vein Wall
Authors: Taccoen A. , Lebard C. , Zuccarelli F. 
Published: January 2017

Objective: To assess the wall perfusion in normal and varicose veins. Design: Observational study. Setting: Departments of vascular surgery of private and public hospitals. Patients: Twenty-seven patients undergoing vein surgery (43 long saphenous veins) and eight controls operated on for femoral-popliteal bypass. Methods: Laser Doppler flowmetry assessing long saphenous vein wall perfusion 3 cm below the saphenofemoral junction. Results: Significantly reduced wall perfusion was shown in varicose long saphenous veins compared with normal veins: 16.3 (SD 10.3) versus 45.4 (SD 14.9); p<0.001. Conclusion: Our data suggest a primary or secondary role for lower perfusion within the vein wall in varicose veins.
Risk of and Prophylaxis for Venous Thromboembolism in Hospital Patients
Authors:   Second Thromboembolic Risk Factors (THRiFT II) Consensus Group
Published: January 2017

Objective: To review the published clinical data on prophylaxis for thromboembolism in order to develop general guidelines to encourage the establishment of local protocols for management. Data sources: Published papers on thromboembolism over the period 1991–1997 were identified by Medline search and/or from the authors' personal literature collections and reviewed. Study selection: A total of 981 studies were identified. Only those papers reporting randomized studies with clearly defined diagnostic methods and clear end-points were included in this review. Data extraction: The available evidence for each specialty was summarized and reviewed by the authors responsible for each specialty, prior to presentation and discussion of their findings within the group. Where a consensus opinion was achieved in a speciality, general guidelines for thromboprophylaxis were summarized. Where a consensus could not be agreed, recommendations for further work were made. Data synthesis: There is evidence to support the preferred use of low-molecular-weight heparins (LMWHs) over unfractionated heparin (UFH) in orthopaedic surgery, major trauma and general surgery. However, the ideal duration of thromboprophylaxis has yet to be defined. The use of once daily subcutaneous administration of LMWH offers major practical advantages and may have significant cost saving implications. Further work is required to investigate the use of thromboprophylaxis in minimal access surgery, trauma, elective lower limb surgery, hip fracture and pregnancy; to compare the efficacy of LMWH and mechanical prophylaxis; and to investigate extended prophylaxis after discharge. Conclusions: There is overwhelming evidence that thromboembolic prophylaxis reduces the incidence of postoperative deep vein thrombosis and pulmonary embolism. Recommendations concerning the management of these patients when stratified into low, moderate and high risk are made with the suggestion that hospitals develop their own guidelines for the treatment of these patients.
The Effect of Compression on Venous Haemodynamics Assessed by Quantitative Photoplethysmography
Authors: Fronek A. , Goldman M. , Fronek K. 
Published: January 2017

Background: The purpose of this study was to examine quantitatively the effect of compression stockings on venous haemodynamics at the level of the ankle. Methods: To obtain quantifiable results, a computer-controlled photoplethysmographic system was used to measure the displacement of local blood volume induced by exercise (exercise displacement volume, EDV) and by tilting the subject (tilt displacement volume, TDV). The test was repeated after application of class I compression stockings 20–30 mmHg). The ratio EDV/TDV is considered to represent the efficiency of the veno-muscular pump. Three groups of subjects were studied: a control group ( n = 8), patients with telangiectases ( n = 10) and a group with large varices ( n = 11). Results: The application of external compression had a quantifiable and beneficial effect on venous haemodynamics and was most significantly documented by an increase in veno-muscular efficiency (EDV/TDV) from 28% to 44% in the varicose vein patients. Statistically significant increases of EDV/TDV could also be identified in the telangiectatic patients and normal subjects. EDV also showed an increase with compression stockings; however, statistical significance was only reached in the varicose vein group. Conclusion: External compression (class 1 compression stockings) significantly improved venous haemodynamic indices, especially in patients with varicose veins. Quantitative photoplethysmography used in this study permits a fast, non-invasive and quantifiable evaluation of venous haemodynamics of the lower extremities.
Design of Randomized Controlled Trials in the Treatment of Leg Ulcers: More Answers with Fewer Patients
Authors: Prescott R. J. , Nelson E. A. , Dale J. J. , Harper D. R. , Ruckley C. V. 
Published: January 2017

Objective: To illustrate the benefit of the factorial design in randomized controlled trials of leg ulcers. Design: A 2 × 2 × 2 factorial design. Setting: Hospital leg ulcer clinics in Edinburgh and Falkirk. Patients: Adults with at least one unhealed leg ulcer of determined origin, present for at least 2 months and greater than 1 cm in diameter. Interventions: Pentoxifylline (Trental) 400 mg, three times daily, versus placebo Main outcome measure: Complete healing of all ulcers within 24 weeks. Results: Of 525 patients screened, 200 pure venous ulcers were randomized (58.5% healed by 24 weeks), 45 complex venous ulcers were randomized (57.8% healed) and 41 arterial patients were randomized (excluding bandaging comparisons) (19.5% healed). There were no interactions between treatments. Conclusion: The factorial design was feasible to administer and allowed three therapeutic questions to be investigated using the same resources as would have been needed to answer a single question.
There is No Benefit from 6 Weeks' Postoperative Compression after Varicose Vein Surgery: A Prospective Randomised Trial
Authors: Raraty M. G. T. , Greaney M. G. , Blair S. D. 
Published: January 2017

Background: It is often recommended that patients should wear compression stockings for 6 weeks after varicose vein surgery. The aim of this trial was to ascertain whether this is necessary. Method: Following a standardised operation for primary varicose veins, patients were randomised to receive postoperative compression with either Panelast Acryl adhesive short-stretch bandages for 1 week or crepe bandages for 16 h followed by 6 weeks wearing of TED antiembolic stockings. Symptoms were quantified by questionnaire and clinical assessment at 1 and 6 weeks. Results: Postoperatively there was significantly more bleeding in the crepe/TED group and a larger area of bruising at the end of the first week (117.5 cm2 vs. 96 cm2, p<0.02; Mann–Whitney U-test). However, this did not correlate with any difference in discomfort or activity between the two groups. There was no statistical difference in the symptoms reported after the first week. Twenty-seven patients out of 52 randomised to TEDs discarded them before the end of the 6 weeks. Both groups returned to full activities and work after similar periods (Panelast 18.5 days vs. crepe 20.0 days). Conclusion: There was no benefit in wearing compression for more than 1 week. Wearing Panelast bandages for the first week did significantly reduce pain on the first postoperative day, bleeding and the extent of bruising.
Iatrogenic Leg Ulcer after Subfascial Endoscopic Perforator Surger (SEPS)
Authors: Huang A. , McWhinnie D. L. 
Published: January 2017

Objective: To report a case of iatrogenic leg ulcer after subfascial endoscopic perforator surgery (SEPS). Design: Case report. Setting: Department of Vascular Surgery, Milton Keynes Hospital, a district general hospital. Patient, intervention and results: A 57-year-old woman underwent SEPS for a venous ulcer secondary to an incompetent perforating vein. Post-operatively she developed a new ulcer directly over the site of the divided perforator. The ulcer healed completely with conservative bandaging treatment after 4 months. Conclusion: We describe a complication of SEPS not previously reported. The perforating artery might have been divided inadvertently instead of the perforating vein. It is important to positively identify the perforating vein during SEPS before its division, especially in the presence of mixed arteriovenous disease.
The Effect of Food on the Absorption of Pivampicillin and a Comparison with the Absorption of Ampicillin Potassium
Authors: Fernandez C A , Menezes J P , Ximenes J 
Published: January 2017

The effect of food on the absorption of pivampicillin hydrochloride and ampicillin potassium was compared in a single-dose, 3-way, cross-over study in fifteen healthy adult subjects. The antibiotics were given in their recommended doses in capsule form: 350 mg of pivampicillin and 500 mg of ampicillin. Ampicillin was administered in the fasting state while pivampicillin was administered both in the fasting state and during a standardized cooked breakfast. The presence of food caused a substantial decrease and delay in the absorption of pivampicillin. Pivampicillin administered during a meal, as recommended to minimize gastro-intestinal irritation, resulted in lower serum levels than those attained with ampicillin given without food. The average peak serum levels of pivampicillin taken during meals was 3.34 mcg/ml compared to 4.47 mcg/ml with ampicillin given in the fasting state. The total antibiotic coverage indicated by time-absorption curves was also considerably lower with pivampicillin than with ampicillin under conditions simulating those recommended during clinical use by the respective manufacturers.
Steroid Contraceptives: Neuro-Psychiatric & Electroencephalographic Complications
Authors: Elwan Osamah , Madkour Obsis , Kamal Ibrahim , Abdallah Mohamed 
Published: January 2017

Eighty women attending the Family Planning Clinic showed negative findings when submitted to a special gynaecological and neuro-psychiatric questionnaire, as well as clinical neuro-psychiatric and electroencephalographic examinations, to exclude present or past menstrual troubles, premenstrual tension symptoms and/or neuro-psychiatric illness. They were divided into eight groups each of ten cases receiving one type of steroid contraceptive throughout the whole period of study. Repeated submission to the previously used neuro-psychiatric questionnaire as well as clinical neuro-psychiatric examination was carried out every three months. EEG tracings were recorded at the end of the trial. Neuro-psychiatric side-effects were noted in sixty-one cases (76.2%). EEG changes were reported in forty-eight cases (60%). It was concluded that both components of the steroid should be included in the pill preferably in minimum concentration. Selective use or relative increase of either components would be associated with more side-effects.
Glipizide: Results of a Multicentre Clinical Trial
Authors: Lahon H F J , Mann R D 
Published: January 2017

This programme has included 177 patients and shown that glipizide is an effective high-potency oral sulphonylurea, which provides an overall satisfactory control rate of 73.7% and a 45% satisfactory control rate in diabetics who have been failures on previous treatment. These comparative studies have shown the efficacy of glipizide to be at least equal to that of glibenclamide. It has been shown that the average daily dose of glipizide is about 12.3 mg/ day with a range of from 1.25 mg/day to the maximum dose of 30 mg/day. The toleration and safety of glipizide is excellent; furthermore, no effect on the liver or renal function was detected and neither ophthalmological roentgenological nor electrocardiographical abnormalities were observed.
Radio-Isotopic Evaluation with 99mTc of Diftalone's Activity on Articular Inflammation: Comparison with Acetylsalicylic Acid and Indomethacin
Authors: Grimaldi M G , Luvarà A 
Published: January 2017

The99m Tc uptake by the proximal interphalangeal joints (2 nd, 3 rd, 4 th, 5 th fingers of both hands) was measured by external directional counting in 24 patients ( three groups of eight patients each) affected by rheumatoid arthritis, before and after five days of treatment with acetylsalicylic acid (3 gm/day), indomethacin (200 mg/day), and diftalone (1000 mg the first day and 750 mg/day subsequently). A significant decrease in the articular uptake was found only in the group of patients treated with diftalone. The differences relative to diftalone were also statistically significant when the results were analyzed comparatively.
Alprenolol in Hypertension: An Open Assessment in General Practice
Authors: Madill F L , Nyberg G 
Published: January 2017

In an open study of alprenolol for hypertension in 100 patients and involving 29 practitioners, the drug was found to he capable of controlling blood pressure to a level of 120 mm Hg mean blood pressure in 79 patients, either alone or in combination with other drugs, at an average dose of 359 mg daily. The average systolic blood pressure fell from 186 to 157 mm Hg, and the average diastolic pressure fell from 112 to 95 mm Hg over 8-12 weeks. Three patients had to withdraw from treatment due to side-effects. Thirteen patients had side-effects of tolerable nature, and 16 patients with side-effects of similar severity on previous treatment suffered less or not at all when switched to alprenolol. These results are very similar to other studies of the same type using other beta-blockers, but the side-effect frequency seems to be lower with alprenolol. This is corroborated by comparative official side-effect reporting over seven years for different beta-blockers.