bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compression Treatment of Chronic Venous Ulceration: A Review
Authors: Moneta G. L. , Nicoloff A. D. , Porter J. M. 
Published: January 2017

Objective: To review the recent medical literature with regard to the use of compressive therapy in healing and preventing the recurrence of venous ulceration. Methods: Searches of Medline and Embase medical literature databases. Appropriate non-indexed journals and textbooks were also reviewed. Synthesis: Elastic compression therapy is regarded as the ‘gold standard’ treatment for venous ulceration. The benefits of elastic compression therapy in the treatment of venous ulceration may be mediated through favourable alterations in venous haemodynamics, micro-circulatory haemodynamics and/or improvement in subcutaneous Starling forces. Available data indicate compressive therapy is highly effective in healing of the large majority of venous ulcers. Elastic compression stockings, Unna boots, as well as multi-layer elastic wraps, have all been noted to achieve excellent healing rates for venous ulcers. In compliant patients it appears that approximately 75% of venous ulcers can be healed by 6 months, and up to 90% by 1 year. Non-healing of venous ulcers is associated with lack of patient compliance with treatment, large and long-standing venous ulceration and the coexistence of arterial insufficiency. Recurrence of venous ulceration is, however, a significant problem after healing with compressive therapy, even in compliant patients; approximately 20-30% of venous ulcers will recur by 2 years. Conclusions: Compressive therapy is capable of achieving high rates of healing of venous ulceration in compliant patients. Various forms of compression, including elastic, rigid and multi-layer dressings, are available depending on physician preference, the clinical situation and the needs of the individual patient. Compressive therapy, while effective, remains far from ideal. The future goals are to achieve faster healing of venous ulceration, less painful healing and freedom from ulcer recurrence.
Peroperative Venography in Sapheno-Popliteal Ligation: Still a Useful Technique
Authors: Cheatle T. R. , Hassan S. A. , Fox J. A. 
Published: January 2017

Objective: To establish the efficacy of peroperative venography in identifying the use of the sapheno-popliteal junction during varicose vein surgery. Design: Single patient group. Setting: District General Hospital, Edgware, Middlesex, UK. Patients: Forty-one patients undergoing sapheno-popliteal ligation for varicose veins of the lower limb. Interventions: Surgical exploration and ligation of the sapheno-popliteal junction. Main outcome measures: Peroperative venographic demonstration of the short saphenous vein and sapheno-popliteal junction. Results: Thirty-four sapheno-popliteal junctions (85%) lay at a site approachable by a conventional incision. Five junctions lay higher than this and one lower. Conclusions: On-table venography is an efficient, quick and reliable way of demonstrating the anatomical site of the sapheno-popliteal junction.
Comparison of Clinical and Photoplethysmographic Assessment of Venous Insufficiency
Authors: Kurgan A. , Lerenbuch L. B. , Gertz S. D. , Shapiro J. , Ofek B. , Shemesh D. , Abramowitz H. B. 
Published: January 2017

Objective: To assess the concordance between clinical and photoplethysmographic evaluation of venous insufficiency. Design: Comparison of two methods of evaluation of venous insufficiency in randomly selected patients. Setting: The Vascular Institute, Shaare Zedek Hospital, Jerusalem, Israel. Patients: Four hundred patients selected at random from a pool of 3000 patients referred to the vascular institute for suspected venous insufficiency. Interventions: Each of the 800 legs was evaluated clinically, by Trendelenburg testing, and by venous reflux photoplethysmography (VPPG). Results: Of 230 legs without clinical evidence of venous insufficiency (including Trendelenburg testing), 214 (93%) were also normal by VPPG. However, of 359 legs with clinical evidence of venous insufficiency, only 178 (50%) were so confirmed by VPPG. Of 135 legs considered to have insufficiency of the deep venous system (DVI) by clinical criteria alone, only 31 (23%) were confirmed to have DVI by VPPG, and 49 (36%) were found by VPPG to have insufficiency of only the superficial system. Conclusions: Reliance upon clinical assessment alone is inadequate for distinguishing between insufficiency of the deep and superficial or perforating venous systems. Assessment by VPPG may identify many patients with dermatologic changes “typical of DVI” who may benefit from superficial venous surgery.
Venous Reflux Localization: Comparative Study of Venography and Duplex Scanning
Authors: Valentín L. I. , Valentín W. H. , Mercado S. , Rosado C. J. 
Published: January 2017

Objective: To compare the results obtained by duplex ultrasound imaging and ascending and descending phlebography in patients with chronic venous insufficiency. Design: Prospective comparison between venography and duplex ultrasound imaging in a single patient group with chronic venous insufficiency. Setting: Private vascular clinic in Puerto Rico. Patients: Twenty-one patients presenting with clinical evidence of venous disease of the lower limb. Main outcome measures: Presence of valvular incompetence in deep and superficial veins as indicated by duplex ultrasound imaging and ascending and descending phlebography. Results: Duplex ultrasound imaging showed twice as many patients with popliteal vein incompetence (eight veins compared with four veins) and twice as many incompetent long saphenous veins (14 detected by duplex, eight detected by venography). In the proximal venous system, 13 common femoral veins were thought incompetent on venography, but only seven on duplex scanning; in the superficial femoral vein, 11 were incompetent on venography and three on duplex scanning. Conclusion: Duplex ultrasound scanning provides greater sensitivity for detection of valvular incompetence in distal veins compared with venography. Descending phlebography is poor in demonstrating distal venous valvular incompetence.
Lower Limb Volume Measurements: Standardization and Reproducibility of an Adapted Optical Leg Volume Meter
Authors: Hebeda C. L. , de Boer E. M. , Verburgh C. A. , Krijnen R. M. A. , Nieboer C. , Bezemer P. D. 
Published: January 2017

Objective: To investigate the reproducibility of an adapted optical leg volume meter and to determine intraindividual volume changes of the lower legs on separate days and in the course of a working day in healthy volunteers. Design: Adaptation of a standard optical leg volume meter, ‘volometer’, and calibration on an artificial leg and on volunteers. Study of the behaviour of lower leg volume in volunteers. Setting: Free University Hospital, Amsterdam. Participants: Thirty-six healthy volunteers, workers in the hospital. Intervention: The lower leg volume was measured on five or six different days at the beginning and end of a full working day. Main outcome measures: Reproducibility of the adapted volometer, and volume changes of the lower legs at different times. Results: Adaptation of the volometer resulted in a reproducibility of 0.07% in an artificial leg and of 0.46% in volunteers. A significant increase ( p<0.0001) in the volume of the lower legs in the course of the day was observed. Conclusion: Adaptation of the optical leg volume meter resulted in reproducible recordings of the volume of lower legs. In the course of the day an increase in volume occurs.
Potential Psychotropic Activity of Phlebotropic Drugs: Weak Interactions with Brain Benzodiazepine Receptors
Authors: Blätter W. , Schoch P. 
Published: January 2017

Background: Epidemiological and psychometric studies have provided evidence that some symptoms of venous disease might reflect a psychosomatic rather than organic disorder. Traditionally, plant extracts are prescribed to alleviate such symptoms. Since benzodiazepines (BZ) and BZ-like compounds are present in various plants, we studied potential interactions of ‘phlebotropic’ drugs with BZ receptors. Methods: Six drug preparations used in phlebology and extracts of hop and valerian were tested for neuronal and mitochondrial BZ receptor binding activity in vitro. In addition, plasma samples of volunteers who ingested phlebotropic drugs for 3 weeks were assayed for the presence of BZ-like activity. Results: All phlebotropic drug preparations interacted weakly with central and/or peripheral BZ receptors in vitro. Their diazepam-equivalent concentrations were, however, too low to be of pharmacological relevance. No binding activity was recovered in the blood of volunteers pretreated with phlebotropic drugs. Conclusion: The positive influence of so-called ‘phlebotropic’ drugs on the subjective symptoms of venous disease is not mediated through BZ receptors.
Injury to the Common Peroneal Nerve during Surgery of the Lesser Saphenous Vein
Authors: Lucertini G. , Viacava A. , Grana A. , Belardi P. 
Published: January 2017

Objective: To evaluate the incidence and associated problems of common peroneal nerve (CPN) injury, which can occur during short saphenous vein (SSV) surgery. Design: A retrospective cohort study. Setting: Section of Vascular Surgery in a University Hospital. Patients: In a consecutive series of 88 patients (31 male, 57 female, ages ranging from 35 to 68 years, mean 49), 104 lower extremities were operated on for SSV insufficiency. Interventions: Each patient was assessed by clinical examination, duplex scanning and in some cases by venography (ascending venography and/or varicography). Surgery was carried out via a longitudinal or transverse approach in the popliteal region or the posterior aspect of the thigh. Main outcome measures: Haemodynamic criteria, cosmetic outcome and complications of the surgical procedures due to SSV insufficiency were considered. In particular, we focused on neurological complications. Results: Abnormality of foot dorsiflexion was observed in two out of 104 (2%) cases. This complication was caused by injury to the CPN. Recovery had occurred 1 year later. Conclusions: Two factors seem to be essential in preventing this neurological complication: (a) good knowledge of surgical anatomy and (b) a cautious, accurate surgical technique. The incidence of this complication has been underestimated, but its importance and medico-legal implications must be emphasised.
Venous Haemodynamics and Morphology in Relation to Recanalisation and Thrombus Resolution in Patients with Proximal Deep Venous Thrombosis
Authors: Rosfors S. , Norén A. 
Published: January 2017

Objective: Follow-up studies of deep venous thrombosis (DVT) are needed to gain increased knowledge of the process of recanalisation over time. In this study modern diagnostic techniques were used to analyse changes in venous circulation during the process of recanalisation and thrombus resolution. Design and setting: Prospective follow-up study of patients with symptomatic DVT referred to a vascular diagnostic laboratory. The patients were evaluated by repeated examinations with colour duplex ultrasound and computerised strain-gauge plethysmography. Patients: Eighteen consecutive patients with acute DVT occluding the calf veins and femoropopliteal vein segments. Main outcome measures: Ultrasonographic assessment of thrombus resolution and flow patterns in deep and superficial veins. Plethysmographic determination of venous volume and venous outflow capacity. Results: At 3 months' and 6 months' follow-up, 33% and 56%, respectively, were recanalised but almost all limbs still had some degree of functional outflow obstruction. Duplex evaluation further demonstrated a complex pattern of recanalisation with thrombus resolution from above, from below or both. Computerised strain-gauge plethysmography showed a progressive time-related increase in venous outflow capacity and venous volume over 6 months, but volumetric variables could not be used to distinguish between limbs with patent veins and those with still-occluded veins. None of the limbs had completely compressible femoropopliteal venous segments at the end of the follow-up. Conclusion: The combination of these two modern diagnostic techniques, suitable for repeated studies, can provide detailed information on morphological and haemodynamic changes occurring during the process of recanalisation and thrombus resolution.
The Impact of Duplex Scanning for the Diagnosis of Deep Vein Thrombosis on Workload in a District General Hospital
Authors: Sudhindran S. , Rosser S. , Pilbrow W. J. , Sissons G. R. J. , de Cossart L. M. 
Published: January 2017

Objective: To assess the impact of changing from ascending phlebography to colour flow duplex (CFD) scanning for the investigation of deep vein thrombosis (DVT) in a District General Hospital and to determine the role of light reflection rheology (LRR) as a Preliminary screening tool for DVT. Design: Retrospective audit. Setting: Vascular Laboratory and Department of Radiology of the Countess of Chester Hospital, Chester, UK. Patients and methods: Audit and review of the all venograms done during the years 1989 to 1991 was undertaken. All the LRR and CFD scans done from 1991 (year of introduction in this hospital) to 1996 were audited and analysed. Outcome measures: Total number of various investigations done for suspected DVT in this hospital from 1989 to 1996 and their detailed analysis. Results: Four hundred and ninety-four venograms were performed between 1989 and 1991, of which 44% confirmed DVT. The least number of venograms was performed in 1991 ( n = 127), after the introduction of LRR. From 1991 through to 1996, the number of LRR scans increased from 90 to 697 and the CFD scans increased from 97 to 786. Conclusion: The audit revealed a 6-fold increase in demand for the examination of limbs for suspected DVT after the introduction of non-invasive tests. LRR continues to be a useful screening tool, reducing the number of CFD scans by 23%.
Clinical Experience with Visken, (Prindolol) in Essential Hypertension: Its Special Comparative Action to Aldomet (Methyldopa)
Authors: Van Coller P E 
Published: January 2017

There is sound statistical evidence that Visken in thirty randomly selected cases was on the average more effective than Aldomet. The results also show that Visken is an excellent drug to lower both systolic and diastolic pressures without a marked effect on posture. Higher systolic and diastolic pressures are lowered more effectively than the lower pressures. The fact also emerges that there is no sound statistical evidence that Visken is more effective for either of the sexes or that efficacy of therapy shows predeliction for a specific age group. Visken was well tolerated and showed no significant side-effects.
A Clinical Trial of a New Anti-Inflammatory/Analgesic Compound in Rheumatoid Arthritis – GP 45 840
Authors: Ghazi S A , Fowler P D 
Published: January 2017

GP 45 840, N-( 2-6-dichlorophenyl)-o-aminophenylacetic acid, sodium salt, has been shown pharmacologically to have good analgesic and anti-inflammatory properties. GP 45 840 in progressively increasing dosage from 50 to 150 mg per day was compared with a placebo in a double-blind cross-over trial in thirteen patients with rheumatoid arthritis, GP 45 840 and placebo each being given for one week. GP 45 840 produced no more intolerance than did placebo therapy. The rather high mean white cell count of the placebo period was lower during treatment with GP 45 840 but n ever below the normal range. GP 45 840 had no effect on weight, erythrocyte sedimentation rate, renal and liver function tests or other haematological tests. The following features were assessed twice weekly; pain, morning stiffness, grip strength, swelling, tenderness, and range of certain joints, requirements of supplementary analgesics and drug intolerance. An improvement, independent of the effects of GP 45 840 was observed in several of the features assessed, including decrease in potentially reversible joint swelling, but GP 45 840 resulted in a further significant reduction in pain and requirements of supplementary analgesics. An anti-inflammatory effect on early synovitis of the p.i.p joints was demonstrated though not conclusively proved. The trial procedures were sufficiently sensitive to demonstrate significant improvement in many symptoms and signs of rheumotoid arthritis due to overall in-patient treatment during a two week period. A new method of analysis of p.i.p size was used. Joints were graded clinically into four categories of joint swelling. Although overall measurements showed no significant change, a significant decrease in joint size was demonstrable in joints graded as having ‘definite’ synovial inflammatory changes.
Anti-Hypertensive Effect of Timolol, a New Beta-Blocking Agent (Double-Blind Study)
Authors: Alcocer Luis , Aspe Julio , Gomez Enrique Arce 
Published: January 2017

The anti-hypertensive effect of timolol maleate (MK-950) was evaluated in patients with mild or moderate hypertension, in a double-blind, randomized, placebo controlled clinical trial. The study was divided into a baseline placebo period, that lasted 9 weeks, during which documentation was made of the patient's untreated diastolic blood pressure. A 9 week titration period followed the placebo period, at which time patients were randomly assigned to an MK-950 or matching placebo group; the titration period was devoted to finding out the optimal dose of MK-950 or its matching placebo. The titration period was followed by a 6 week maintenance period during which patients were maintained on their optimal MK-950 or placebo dose. Timolol is an effective anti-hypertensive drug and significantly reduces diastolic blood pressure. Its effect becomes apparent at the first week of treatment, and reaches maximum effectiveness at 4 weeks of treatment. The diastolic blood pressure in the timolol group remained consistently below 90 mm Hg and at the end of the study, the average diastolic blood pressure was: 88·57 ± 8·6 mm Hg (p > 0·001 in comparison with placebo). The average daily dose of timolol maleate was 31·10 ± 1·80 mg. MK-950 has a strong negative chronotropic effect, capable of reducing the resting heart rate by an average of 28·50 beats/min. No correlation could be established between heart rate and blood pressure lowering effect. Other than bradycardia, no important side-effects were observed.
A Comparative Trial of Minocin (Minocycline Hydrochloride) and Ampicillin in the Treatment of Acute Exacerbations of Chronic Bronchitis
Authors: Burrow G R F , Fox A S , Daniel R J E 
Published: January 2017

One hundred and fifteen patients suffering from acute exacerbations of chronic bronchitis took part in a double-blind, multicentre, clinical trial designed to compare the therapeutic efficacy and tolerability of ampicillin and minocycline hydrochloride, a new, long-acting, semi-synthetic tetracycline. Both antibiotics were equally successful in treatment, there being no statistically significant difference between the two in any of the parameters studied. Side-effects were few and far between. Only one patient out of the 57 who took minocycline, complained of dizziness.
A Controlled Clinical Comparison of Nasal Decongestants in Acute Rhinitis
Authors: Meurman O H 
Published: January 2017

Three familiar commercial nasal decongestants were compared in a doubleblind trial using patients suffering from acute rhinitic conditions. Variables measured were quantity of medication used within a given period of time, onset of action, frequency of application and duration of action. It was shown that in a given period of time the use of one trial product was significantly lower than that of the two other products with regard to establishing and maintaining free nasal breathing. There were indications that special biopharmaceutical factors in a product could control patients' self-dosage of the preparation thereby improving the risk/benefit relation considerably. Another important conclusion was that the patient himself could handle a medicine reasonably and responsibly thereby providing valuable additional data for evaluation of a product under trial (consumer orientated research).
A Multicentre Trial to Evaluate the Efficacy and Tolerability of α-Glycerylphosphorylcholine versus Cytosine Diphosphocholine in Patients with Vascular Dementia
Authors: Perri R. Di , Coppola G. , Ambrosio L.A. , Grasso A. , Puca F.M. , Rizzo M. 
Published: January 2017

An open clinical trial was carried out to compare the efficacy and the tolerability of 1 g/day α-glycerylphosphorylcholine (α-GPC) with 1 g/day cytosine diphosphocholine (CDP) both given intramuscularly for 90 days in 120 patients with mild to moderate vascular dementia. The clinical evaluation, carried out at the start as well as halfway through (45 days) and at the end of treatment (90 days), was expressed by psychometric tests (modified Parkside behaviour rating scale, Sandoz clinical assessment geriatric scale, word fluency test, Hamilton's rating scale of depression, narration subtest of Wechsler memory scale). Both treatments produced a definite symptomatic improvement and showed a very good tolerability. The results suggest that in most tests α-GPC possessed a statistical higher efficacy and an overall more satisfactory activity assessed by both patients and investigators compared with CDP. E’ stato effettuato uno studio clinico in aperto per confrontare l'efficacia e la tollerabilità di α-glicerilfosforilcolina (α-GFC) alla dose di 1 g al giorno verso citosina difosfocolina (CDP) sempre alla dose di 1 g al giorno, somminístrate entrambe per via intramuscolare per 90 giorni in 120 pazienti affetti da demenza vascolare di grado da lieve a medio. La valutazione clinica, effettuata all'inizio, a metà (45 giorni) e al termine del trattamento (90 giorni), è stata effettuata con test psicometrici (modified Parkside behaviour rating scale, Sandoz clinical assessment geriatric scale, word fluency test, Hamilton rating scale per la depressione ed subtest del racconto della Wechsler memory scale). Entrambi i trattamenti hanno indotto un miglioramento della sintomatologia e hanno presentato una buona tollerabilità. I risultati mostrano che, nella maggior parte dei test, α-GFC ha presentato una più elevata efficacia, a confronto con CDP, come confermato anche dalle valutazioni soggettive espresse dai pazienti e dagli esaminatori.
The Vitamin-E-Deficiency Syndrome in Pigs; III. Light- and Electron-Microscopic Studies on Myocardial Vascular Injury
Authors: Nafstad Inger 
Published: January 2017

Vascular changes in the myocardium of vitamin-E-deficient pigs were studied by light and electron microscopy. The main changes shown by light microscopy were mural degeneration and multiple microthrombi in small vessels. The thrombotic material gave staining characteristics of platelets and fibrin. With electron microscopy, the main changes were endothelial damage, extravasation of platelets and erythrocytes, and the formation of thrombi composed of platelets and fibrin. The first vascular change occurred in the endothelium; this was succeeded by the formation of thrombi.