Phlebologie最新文献

We have led a microcirculatory and functional research of skin adnexa over 3 groups of 20 people each, who were affected with IVC at different grades and we have compared them to another group of 20 normal people. The microcirculatory researches (laser-Doppler, skin oximetry and thermometry) and functional ones of skin adnexa (sebometry and skin hydration) allowed us to get a nonunivocal behaviour between normal subjects and phlebopathies of I degree. For this reason, it is possible to consider these exams as screenings tests to determine the starting phases of phlebopathy, failing any skin marks. The reduced fluximetrical response taken by laser Doppler after postural variation and the reduction of hydration degree have been considered particularly significant.

By their tensing and relaxation, the muscles of the leg are thought to be responsible for compressing and relaxing the vascular walls and the lumen of vessels. In order to study the way the muscle structure of the lower limb (in particular the leg and the foot) functions, it is necessary to understand the step and break down its components. The weight of the body is transmitted to the ground by the astralagus which distributes the different forces throughout the fives systems of ossei trabeculae of the astralagus and the heel. The valgus heel determines a continuous traction on the tendon and the hind leg muscle which determines with time a dragging of the foot. When the body goes forward, the weight levels the transverse fore arch. The flexor muscles of the toes bend the phalanxes, gripping them to the ground, they avoid the falling forward of the body with the proximal insertion on the tibia. The sesamoids increase the muscles power as well as that of the kneecap on the quadriceps. The internal curvature of the foot on the ground is furthered by the decreasing length of the metatarsal bones. This is counterbalanced by the long fibular muscle which lowers the medial axis and raises the external axis. The supination of the forefoot depends only in part on the varus valgus of the rear of the foot. The plantar aponeurosis and the flexor tendons have an impact on the metatarsi because they increase the power and bring the insert closer. The complex articular system of the feet depends on the extrinsic and intrinsic muscle structure which, at the same time as a position variation can also play an important part in the venous alteration.

The author reports the conclusions of a multicentre investigation lead in Germany. According to this study, varicose veins are more frequent in women than in men, either in ordinary population or in in-patients. Adults are not exclusively the only ones who suffer from varicose veins; children often suffer from them too. People suffer equally from phlebitis or post phlebitis syndromes. Moreover, heredity and obesity tend to favour this tendency. Thus, the socio-economic impact is so important that the cost of treatment, hospitalization and the social cost of sick-leave must be taken into consideration. So, it is necessary for the Authorities to prevent venous diseases and be aware of the importance of phlebology.

Gastrocnemical insufficiency is a common syndrome (in modern society mainly affecting young females who have been taking the pill for several years). Often it is the starting point for superficial varicosis. The clinical diagnosis is easy, provided the doctor is informed of its symptoms. Phlebography or Duplex scan are compulsory, deciding surgical treatment. Varicose muscular veins have two different causes: avalvulation at the popliteal vein or compression by the Post. Tib. nerve. Persistent pain, deterioration of the superficial network or neuromyositis are the main reasons for deciding upon surgical treatment. The results are gratifying and lasting.

In order to set up a common and objective language for everyone, the authors have laid the foundation of anatomoclinical classification which can be used as a reference in the study of varicose veins in lower limbs. They are comparing a group of patients with varicose veins to a control group of healthy patients. The groups are classified in four stages according to the importance of the varicose pathology and the histological characteristics. The conclusion is the following: there is no parallelism between these four clinical stages and the histological characteristics. According to the authors, it is necessary to make a distinction between fibrous reaction veins and muscular wall veins. This phenomenon is reported to have particular therapeutic implications in the prescription of substances of exciting venous tonicity.

Patient often think that the pains of their extremities (especially during the night) are caused by a plebo or an angiopathy whereas they are in fact due to a vertebral or lumbar discal affection. 84 patients with osteoporosis were treated by an intramuscular injection of deca-durabolin (25 mg/month) and calcium phosphate (tertiare). Results were satisfactory: six months later, 62 patients no longer suffered, 13 had felt improvement and 2 remained unchanged.

The writers reminded that a consensus on Classification of veinous diseases, necessary to build up homogeneous samples, was being set up. Now, they are introducing a thermal nosology that is as useful. Next, the history of spas, the characteristics of Thermal Springs and thermal practices as well as their results are described. The writers present a standardization of the observation and control parameters of the therapeutic effects. The rigorous and scientific process was defined by an interdisciplinary scientific process was defined by an interdisciplinary scientific Council and it is based on the creation of a Computerized Laboratory of Research and a Thermal University. It has become an example in the field of thermalism. According to the results and the modern indications, the water cure has to be prescribed at an early stage. The practitioner must think about it and insert the water cure in the arsenal of veinous diseases. According to the hydrogeologists' estimates, BARBOTAN les thermes, the first European spa with about 22,000 patients is thought to possess enough water to allow from 40,000 to 60,000 people to be treated yearly. A thermal environment is the ideal place for an efficient vascular rehabilitation and functional re-education. In phlebology, more than one million people should benefit from a water cure yearly ... Only 70,000 follow this treatment. Everyone has to wonder about this situation, which, to those who do not benefit from a thermal cure in phlebology, is as astonishing as prejudicial.

Looking at the bibliography of the venous sole of the foot (Lejars), the authors point out the opposite convictions concerning this structure. For some ones, it doesn't exist, but fort the others, it is a very important network of tiny veins, such as it was described by Lejars himself. However, all this studies, are made upon cadavers, injected or not, and must be compared with results from living people by the mean of angiography, non invasive Vascular Assessment, or RMN, which take in account vasomotricity.