bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biochemical and Histological Analysis of Collagen and Elastin Content and Smooth Muscle Density in Normal and Varicose Veins
Authors: Travers J. P. , Dalton C. M. , Baker D. M. , Makin G. S. 
Published: January 2017

Objective: Determination of the ratio of collagen and elastin to protein content of varicose/non-varicose veins from calf and determination of collagen, elastin and smooth muscle density of varicose/non-varicose vein walls. Design: Prospective study; control vein samples obtained from amputees for ischaemic vascular disease and varicose vein samples obtained from an equivalent Position following surgical stripping. Setting: Departments of Human Morphology and Vascular Surgery, Queen's Medical Centre, University of Nottingham, UK. Patients: Seven patients with no evidence of venous disease treated by amputation of the lower limb for vascular disease and 12 patients treated for varicose veins by ligation and stripping of the long saphenous vein. Interventions: Vein sections were examined biochemically and histologically using stereological techniques. Main outcome measures: Biochemical quanitfication of collagen, elastin and protein and stereological analysis of collagen, elastin and smooth muscle density of varicose and non-varicose veins. Results: There was no difference between the collagen/Protein or elastin/protein ratio in varicose and normal veins but there was a significant increase in muscle density with corresponding decrease in collagen and elastin density in the walls of varicose veins compared with non-varicose vein controls. Conclusions: There were no differences in the collagen or elastin content of varicose veins when compared with non-varicose veins. Smooth muscle hypertrophy occurs in varicose veins, which appears to disrupt the collagen/elastin lattice of the vein wall.
A Randomized Trial of Biofilm Dressing for Venous Leg Ulcers
Authors: Smith J. M. , Doré C. J. , Charlett A. , Lewis J. D. 
Published: January 2017

Objective: Comparison of Biofilm dressing with Jelonet and Betadine in the treatment of venous leg ulcers. Design: Randomized parallel-group controlled trial, stratified by initial maximum ulcer diameter of 2–4 cm or >4 cm. Setting: Community. Patients: Five hundred and twenty-nine patients were assessed and 200 patients with clinical evidence of venous leg ulceration and initial ulcer diameter >2 cm were recruited to the trial. Patients with appreciable arterial disease (ratio of ankle to brachial systolic pressure <0.75) were excluded. Interventions: Ulcers were treated with either Biofilm (a hydrocolloid dressing) or Betadine and Jelonet in the community for 4 months or until the ulcer healed, if sooner. All patients wore standardized graduated compression. Main outcome measures: Time to complete healing of the ulcer, subjective assessment of pain and total cost of treatment. Results: Healing was more rapid in patients using Biofilm dressing (relative risk 1.16, 95% confidence interval 0.8–1.8), but not significantly so p = 0.48. Patients' subjective pain scores after 1 month of treatment indicated there was significantly less pain experienced by patients treated with Biofilm ( p = 0.02). The total cost of treatment (including dressings and nursing time) was similar for Biofilm and Betadine for small ulcers (<6 cm) but Biofilm cost three times as much for larger ulcers. Conclusion: Provided that standardized graduated compression was used, the primary dressing did not significantly affect the time to complete healing of the ulcer.
Compression Stockings and Venous Function in Patients with Decompensated Heart Failure
Authors: Kierkegaard A. , Norgren L. 
Published: January 2017

Objective: To measure the abnormalities of venous function in patients with decompensated heart failure. Design: Single group study. Setting: Departments of Medicine and Surgery, Lund University Hospital, Lund, Sweden. Patient: Forty-seven patients with decompensated heart failure due to myocardial insufficiency. Interventions: Conventional medical treatment for decompensated heart failure. The application of graduated compression stockings randomly applied to one leg. Main outcome measures: Strain gauge plethysmography assessment of venous capacitance and maximum venous outflow. Results: Graduated compression stockings increased venous volume significantly, but did not influence maximum venous outflow. Conclusion: The principal effect of compression stockings is probably a direct effect upon the veins in the leg in patients with decompensated heart failure.
A Correlation between Blood Flow Volume and Ultrasonic Doppler Wave Forms in the Study of Valve Efficiency
Authors: Beckwith T. C. , Richardson G. D. , Sheldon M. , Clarke G. H. 
Published: January 2017

Objective: To demonstrate a significant correlation between the Doppler waveform and blood flow volume in the assessment of valve efficiency. In particular the objective was to ratify use of the ‘area index’ of the wave form. Design: Pearson's correlation and zero line assessment were used. Using a phantom, multiple tests were performed so that a wide spectrum of flow volumes could be compared with corresponding Doppler waves. Setting: Private diagnostic imaging clinic with vascular surgical association. Main outcome measures: The hypothesis was that there should be a significant correlation between the Doppler wave and the blood flow volume and, in particular, the Doppler area. Results: The Doppler wave index EId demonstrated the highest correlation coefficient ( r = 0.97, p<0.01) when compared with the volume index EIV. Conclusion: While there is a strong correlation between EId and flow volume, additional study is needed to determine its place in the clinical setting.
The Influence of Effective Analgesia and General Anaesthesia on Patients' Acceptance of Day Case Varicose Vein Surgery
Authors: Onuma O. C. , Bearn P. E. , Khan U. , Mallucci P. , Adiseshiah M. 
Published: January 2017

Objective: To assess the efficacy of locoregional anaesthesia and non-opiate analgesia in controlling pain after varicose vein surgery. To examine patient attitudes to day case surgery for this condition. Design: Prospective single patient group study (22 consecutive patients). Setting: University College Hospital (Teaching Hospital). Intervention: Locoregional and general anaesthesia. Non-opiate analgesia. Surgical treatment for varicose Main outcome measures: Patient interview, pain scores, analgesia requirement. Result: Post operative Pain was absent in 36% during the first 24 hours. Oral analgesia was given to 36% as inpatients but only 18% after discharge. Before surgery, 95% would have preferred DCS but only 24% at six months. The after-effects of general anaesthesia was the main reason for this change in attitude. Conclusions: Patients would like day case surgery for varicose veins but anaesthesia and analgesia must be satisfactory.
A Modified Technique for Stripping of the Long Saphenous Vein
Authors: Bearn P. , Fox J. A. 
Published: January 2017

Objective: To describe a modification of the standard stripping technique that facilitates varicose vein surgery, avoiding unsightly scars and damage to the venous nerve. Interventions: Long saphenous vein stripping using a modified standard stripping device. Conclusions: The modified stripper provides a satisfactory method of removing the long saphenous vein without resulting in large scars.
Skin Blood Flow in Chronic Venous Insufficiency
Authors: Shami S. K. , Chittenden S. J. , Scurr J. H. , Smith P. D. Coleridge 
Published: January 2017

Objective: To evaluate the skin temperature, laser Doppler flux (LDF), concentration of moving blood cells (CMBC) and speed of blood cells (SBC) in the liposclerotic and clinically normal skin of patients with chronic venous insufficiency. Design: Parallel groups study comparing patients with chronic venous insufficiency with control subjects. Setting: Vascular laboratory, Middlesex Hospital, University College and Middlesex School of Medicine, London, UK. Participants: Twenty patients with lipodermatosclerosis and chronic venous insufficiency comprised the disease group, and 15 subjects without venous disease comprised the control group. Main outcome measures: The skin temperature, LDF, CMBC and SBC were assessed in the gaiter area and on the dorsum of the foot. Results: A higher LDF (median LDF and interquartile range (IQR) = 132 (66–289), p = 0.001 (Mann-Whitney) and skin temperature (Median temperature and IQR = 31.1 (29.6–32.4), p = 0.001) was found in the liposclerotic skin of patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 49 (32–58); median temperature and IQR = 28 (27–30.3)). Similarly the LDF on the dorsum of the foot (median LDF and IQR = 73 (59–127), p = 0.03) and skin temperature on the dorsum of the foot (median temperature and IQR = 31.1 (30.4–32.1), p = 0.002) was significantly higher in the patients with chronic venous insufficiency compared with normal controls (median LDF and IQR = 55 (36–66), median temperature and IQR = 29.5 (26.7–30.7)). Conclusions: This study demonstrates that there is increased skin blood flow in both liposclerotic skin and clinically normal skin in patients with chronic venous insufficiency.
A Double-Blind Clinical Trial of the Efficacy and Tolerability of O-(β-Hydroxyethyl)-Rutosides and Compression Stockings in the Treatment of Leg Oedema and Symptoms following Surgery for Varicose Veins
Authors: Kranendonk S. E. , Koster A. M. 
Published: January 2017

Objective: To study the efficacy and tolerability of O-(β-hydroxyethyl)-rutosides (HR) and compression stockings in the treatment of leg oedema and symptoms after varicose vein surgery. Design: A prospective double-blind, randomized, Parallel, placebo-controlled trial. Setting: Surgical department of a regional hospital. Patients: Forty patients undergoing venous surgery for varices associated with superficial insufficiency. Interventions: Saphenofemoral ligation, stripping of the entire long saphenous vein and removal of varicosities via 0.5 cm incisions. HR was given at 2 g/day (or Placebo) for 6 weeks starting on the first postoperative day. Twenty patients were randomized to each group. Main outcome measures: Leg volumes were measured by an automatic electronic-optic volumeter, prior to operation and again after 6 weeks and 3 months. Leg symptoms were recorded on days 1 and 10, weeks 3 and 6, and at 3 months. Results: There was no difference in leg volume between the two groups during the first 6 weeks when stockings Were worn, but the increase in oedema of the distal leg in the subsequent 6 weeks was significantly less in the HR group. Symptoms disappeared rapidly 3 weeks Postoperatively in both groups. Conclusions: Stockings are effective in controlling postoperative leg oedema and symptoms. The addition of HR can prevent subsequent oedema after removal of the stockings.
Valves in Varicose Veins and External Compression Studied by Angioscopy
Authors: Van Cleef J. F. 
Published: January 2017

Aim: To explain the mechanism of action of external compression in venous/valvular incompetence Design: Prospective investigation in single patient group. Setting: Notre Dame de Bon Secours Hospital, Paris, France. Patients: Four patients presenting with primary varicosities undergoing surgical treatment. Interventions: Dynamic saphenous vein angioscopy with application of external compression to the limb. Main outcome measures: Angioscopy assessment of venous valvular incompetence. Results: External compression failed to abolish reflux in valves where there was an intercorneal space at the valve commissure.
‘Pin-Stripping’: A Novel Method of Atraumatic Stripping
Authors: Oesch A. 
Published: January 2017

Objective: To assess the efficacy of a new technique for stripping segments of the short saphenous vein (SSV) or long saphenous vein (LSV). Design: Preliminary report on 83 cases. Patients: Seventy-five patients with incompetence of the SSV or LSV. Interventions: Forty-two partial Strippings and one complete stripping of the SSV; 40 Strippings of segments of the LSV. Results: The method described (‘Pin-stripping’) permits stripping without visualization of the distal end of the vein. Removal of the vein is possible through a stab incision and is feasible under local anaesthesia. Operation time is reduced and no postoperative complication was seen. Conclusions: Compared with conventional Strippings, ‘Pin-stripping’ offers several advantages in removing segments of the LSV or SSV.
Immunohistochemical Localization of Factor XIIIa in Chronic Venous Insufficiency
Authors: Vanscheidt W. , Laubert A. , Laaff H. , Weiss J. M. , Schöpf E. 
Published: January 2017

Objective: Factor XIIIa (FXIIIa) of the coagulation cascade (fibrin stabilizing factor) plays a crucial role in wound healing. Its plasma activity is significantly decreased in patients suffering from diseases accompanied with pathologically increased uptake of fibrin. Design: Immunohistochemical localization of FXIIIa and immunofluorescent histological labelling of fibrin in patients' biopsies and in control specimens. Procedure: Twenty-five biopsies were taken from granulation tissue of venous ulcers. Specimens of unimpaired wound healing ( n = 10) served as controls. Concentrations of FXIIIa and fibrin were estimated in all biopsies. Additionally, 10 biopsies from ulcer edges were stained with FXIIIa. Results: The fibrin uptake in ulcer tissue exceeded the amount found in control biopsies. Specimens taken from the ulcer edges contained the greatest amount of FXIIIa in both pericapillary and interstitial regions, followed by the controls. Granulation tissue taken from venous ulcers showed less FXIIIa around capillaries and in the interstitium than specimens of both other groups. Conclusion: Local FXIIIa deficiency in ulcer tissue may contribute to impaired wound healing. Sclerosis found in ulcer edges may be the morphological correlate of the high enzymatic concentrations found in specimens from this area.
Morphological Study of the Valvular Distribution in the Long Saphenous Vein
Authors: Ortega F. , Sarmiento L. , Mompeo B. , Centol A. , Nicolaides A. , Leon M. , Christopoulos N. 
Published: January 2017

Objective: To measure the distribution of valves in the long saphenous vein. Design: Morphological study of the intervalvular distance of the long saphenous vein. Setting: Department of Morfología, Facultad de Ciencias de la Salud (Universidad de Las Palmas de Gran Canaria, Spain) and Academic Vascular Surgery Unit, St Mary's Hospital, London, UK. Material: Twenty lower extremities from adult cadavers with no evidence of lower limb venous disease. Methods: Anatomical dissection of the long saphenous vein, with accurate measurement of valve distribution. Results: There were on average 8.7 valves in the long saphenous vein, with 6.3 above the knee and 2.4 below the knee. Conclusion: Contrary to classical anatomical texts on this subject there are more valves in the long saphenous vein in the thigh than in the calf.
Placebo Treatment for Varicosity: Don't Eat It, Rub it!
Authors: Saradeth T. , Resch K. L. , Ernst E. 
Published: January 2017

Objective: To define and compare the clinical effectiveness of two different placebo applications, oral and topical, in the management of primary varicose veins. Design: Prospective, controlled trial with two parallel treatment groups. Setting: Social security system related rehabilitation centre in Germany with nationwide assignment of inpatients. Patients: Sixty-one patients with the clinical diagnosis of varicose veins. Interventions: Group A ( n = 30) received an oral placebo, group B ( n = 31) applied a topical placebo preparation to both legs. The treatment period was 24 days; both therapies were applied daily. Main outcome measures: Foot volume, ankle circumference, light reflex rheography and subjective complaints. Results: In both groups there were significant improvements in several outcome measures concerning both objective signs and subjective symptoms. Light reflex rheography yielded significantly better results in the topically compared with the orally treated group. Other variables followed this trend without, however, reaching the level of statistical significance. Conclusions: Symptoms of varicose veins are highly prone to respond to placebo. There are some indications to suggest that a topical placebo induces stronger effects than an oral one.
Evaluation of a New Venoactive Micronized Flavonoid Fraction (S 5682) in Symptomatic Disturbances of the Venolymphatic Circulation of the Lower Limb: A Double-Blind, Placebo-Controlled Study
Authors: Gilly R. , Pillion G. , Frileux C. 
Published: January 2017

Objective: To determine the effect of a new venoactive flavonoid fraction (S 5682) in the treatment of symptomatic disturbances of the venolymphatic system. Design: Double-blind, randomized, placebo-controlled, Parallel group trial conducted in two centres. Setting: Department of Internal Medicine, La Palmosa Hospital, Menton, France, and Department of Vascular Surgery, Kremlin-Bicêtre University Hospital, Le Kremlin-Bicêtre, France. Patients: One hundred and sixty patients with symptomatic disturbances of the venolymphatic system, including chronic venous insufficiency, were included in the study. Interventions: Treatment lasted 8 weeks and consisted of the daily administration of two tablets of either S 5682 ( n = 80) or placebo ( n = 80). Main outcome measures: The primary end-point was the evolution of eight symptoms of disturbance of the venolymphatic system over the 2-month observation Period. The secondary end-point was the change of circumference of each affected leg over the same observation period. Results: When compared with placebo, S 5682 led to a significant improvement in four symptoms (functional discomfort, sensation of heaviness, nocturnal cramps, sensation of swelling) at week 4 and in two additional symptoms (pain and sensation of heat or burning) at week 8. Similarly, S 5682 was associated with a significant decrease in calf muscle and supramalleolar circumferences at week 4 ( p < 0.001) and week 8 ( p < 0.001) reflecting a reduction of oedema. The decrease of the supramalleolar circumference correlated well with the improvement of the swelling sensation ( r < 0.56; p < 0.001). The clinical and biological acceptability of S 5682 was good. Conclusions: These results indicate that S 5682 shows early and prolonged efficacy in the treatment of symptomatic disturbances of the venolymphatic system, including chronic venous insufficiency, without significant side-effects.
Is Arterial Disease a Risk Factor for Chronic Leg Ulceration?
Authors: Fowkes F. G. R. , Callam M. J. 
Published: January 2017

Objective: To compare extent of arterial disease in chronic leg ulcer patients and controls without leg ulcer. Design: Case control study. Setting: Lothian and Forth Valley Leg Ulcer Study (patients) and Edinburgh Artery Study (controls). Patients: 331 leg ulcer patients aged 55–74 years identified in a population survey and 331 age- and sex-matched population controls. Interventions: Questionnaires which included cardiovascular history. Measurement of ankle and brachial systolic pressures. Main outcome measures: History of intermittent claudication, previous heart attack, hypertension, diabetes mellitus. Lower ankle brachial pressure index (ABPI) of either leg. Results: Frequencies of intermittent claudication, previous heart attack, hypertension and diabetes mellitus were very similar between the study groups. Mean (SE) ABPI was 1.1 (0.01) in patients and 1.0 (0.01) in controls ( p < 0.001), although the difference was due partly to variation in measurement techniques. Conclusions: Arterial disease was not found more frequently in patients than in controls, suggesting that arterial disease is not a risk factor for chronic leg ulceration, but clarification is required from other studies.
Ultrasound for Cutaneous Wound Healing
Authors: Ernst E. 
Published: January 2017

Objective: To review the published data on ultrasound as a means to enhance wound healing. Study selection: A combined computerized (Medline 1980–94) and manual search of the world literature was performed. Data extraction: All controlled trials on cutaneous wound healing were admitted. Three experimental and five clinical studies were retrieved. Data synthesis: The experimental studies imply that cutaneous wounds treated with ultrasound heal quicker than untreated wounds. Clinical trials suggest that ultrasound speeds the healing of leg ulcers and possibly also of pressure sores Conclusion: Ultrasound is a promising adjunct to the complementary treatment of wounds, which would need more detailed, definitive study.
Two-Dimensional Laser Doppler Perfusion Imaging and Microcirculatory Function in Patients with Venous Skin Damage
Authors: Cheatle T. R. , Quashie C. , Villemur B. , Carpentier P. 
Published: January 2017

Objective: To assess the use of two-dimensional laser Doppler perfusion imaging in the quantification of venous skin damage. Design: Comparison of disease group with control group. Setting: Department of Medicine, Hôpital du Nord, Grenoble, France. Subjects: Six patients (nine limbs) with lipodermatosclerosis (LDS) due to duplex-proven venous insufficiency and six controls subjects (11 limbs). Interventions: Perfusion images were collected at rest, after venous hypertension and after skin heating. Main outcome measures: Mean skin perfusion (mV). Results: An increased basal flux at rest was found in lipsclerotic skin (1.6 V) compared with controls (0.94, V, 95% CI = 0.16–1.48). An impairment of hyperaemic responsiveness to heat was also shown (factor of increase = 1.87 (LDS) compared with 3.28 (controls); 95% CI = 0.85–2.44).
A Rare Case of an Aneurysm of the External Iliac and the Common Femoral Vein
Authors: Labropoulos N. , Volteas S. K. , Kutoubi A. Al , Nicolaides A. N. , Mansfield A. O. 
Published: January 2017

Objective: To report a case of an external iliac – common femoral vein aneurysm and review the literature on the subject. Design: Case report. Setting: Academic Vascular Surgery and Radiology Units, St Mary's Hospital, London, UK. Patients, Interventions and Results: The aneurysm occurred in a 34-year-old woman and was diagnosed with venography, duplex scanning and magnetic resonance venography. It underwent acute thrombosis and, as the thrombus was well organized and extensive, thrombectomy was not possible. The patient was treated with standard heparin followed by oral anticoagulants for 5 months. Thirty months after the operation the right calf remains swollen but soft and non-tender and the patient is currently treated with grade II full-length compression stockings. Since there were no findings of vein compression or malignancy it seems that the formation of the aneurysm resulted from a congenital weakness of the venous wall. Conclusions: The most common presentation of these aneurysms is of a mass of the abdomen or the iliac fossa, while thromboembolism is not uncommon. The main causes are arteriovenous (AV) fistula formation and congenital weakness of the vein wall. For the first the preferred treatment is AV fistula ligation while for the rest ligation with or without vein reconstruction has been successfully used.