Phlebology最新文献

Aim: This study aimed to monitor public interest in information related to Lipedema and examine potential temporal, seasonal, and income-related trends that may impact public interest.

Material – methods: A dataset was created using the Google Trends tool by inputting the keyword "Lipedema" to obtain the relative search volume (RSV) from 2004 to the present in the United States (US). To examine potential income-related disparities in public interest in Lipedema across the US, RSV values were recorded in the five states with the highest and the lowest median income (Maryland, New Hampshire, New Jersey, Utah, and Washington and Mississippi, West Virginia, Arkansas, New Mexico, Kentucky, respectively).

Results: Public interest in Lipedema increased significantly over time (R² = 0.693, p < .001 for the linear trend; R² = 0.880, p < .001 for the quadratic trend). There were no significant differences between the RSV values between the month of the year and the season of the year (p = 1.000 and p = .859, respectively). RSV values of the five highest-income and low-income states showed significant increases (R² = 0.333, p < .001, and R² = 0.195, p < .001, respectively) More rapid growth in interest in Lipedema in states with high income compared to the states with low income (p < .001).

Conclusion: Public interest in Lipedema is increasing in both high-income and low-income states. States with higher incomes are more interested. Searches for lipedema are expected to become more frequent, leading to a rising demand for comprehensive education in medical schools and clinician training programs. In addition, there will also be a need for easily accessible, high-quality information resources.

Objective: Leg pain has long been underestimated despite being one of the most important symptoms of chronic venous disease (CVD). Studies investigating leg pain and psychosocial profile in CVD are limited. The study aimed to investigate leg pain, central sensitization, kinesiophobia, and body awareness in patients with CVD. Methods: The ninety-eight patients (80 female, 18 male) diagnosed with CVD were included in the study. The severity of leg pain was evaluated with the Visual Analog Scale (VAS). The patients were assessed with the Central Sensitization Inventory (CSI-A and B) for central sensitization-related symptoms and -positivity, the Body Awareness Questionnaire (BAQ) for body awareness, and the Tampa Kinesiophobia Scale (TKS) for kinesiophobia. The cut-off score was admitted as 41 for TKS. Results: The leg pain (mean (SD) = 4.3 ± 2) and body awareness (mean (SD) = 82.4 ± 22) were moderate levels in patients with CVD. Nearly half of the patients (n = 46, 46.9%) had both central sensitization positivity and elevated kinesiophobia (n = 46, 47%). The CSI was correlated with the VAS (r = 0.32, p = .001), TKS (r = 0.40, p < .001), and BAQ (r = 0.20, p = .048). Significant correlations were determined between Body Mass Index and TKS (r = 0.48, p < .001) and BAQ (r = -0.31, p = .002). Also, the patients with a TKS score ≥41-points had higher CSI-A scores (p = .002) than those with a TKS score< 41. Conclusions: Leg pain, central sensitization, and kinesiophobia are commonly seen in patients with CVD, and central sensitization seems to have a negative effect on leg pain, kinesiophobia, and body awareness. The profile beyond pain should be evaluated in detail, and various rehabilitation strategies need to be developed to manage central sensitization, interoception, kinesiophobia, and weight control in patients with CVD.

Background: To analyze the perception of vascular surgery trainees from Italian schools of Vascular Surgery regarding the level of practical and theoretical education in venous diseases.

Methods: An anonymous electronic survey was sent to Italian vascular surgery residents affiliated with 19 universities, asking about their training and experience in the management of venous diseases. The survey gathered information on the residents' personal and demographic details, their university's teaching program, operative experience in phlebology, as well as their confidence levels in performing various venous procedures, with the goal of analyzing the training and learning programs provided by Italian vascular surgery schools.

Results: The analysis showed that 28% of programs do not include phlebology in the curriculum, and more than 40% of residents are unable to independently perform venous duplex ultrasound or treat venous ulcers. Additionally, most residents (over 70%) have limited weekly exposure to phlebology cases, with only 5% having access to a dedicated phlebology operating room. The vast majority of residents (96%) expressed a strong desire to deepen their knowledge and skills in this field, particularly in areas such as endovascular ablation techniques, venous duplex ultrasound, and management of deep venous disease.

Conclusions: The survey reveals significant limitations in phlebology education and hands-on experience within the current training programs, highlighting the need to standardize and enhance venous disease management education in order to ensure that future vascular surgeons are adequately equipped to provide high-quality care for patients with a wide range of venous disorders.

Objectives: This study aimed to evaluate the effectiveness and safety of different dosages of calcium dobesilate in the management of Chronic Venous Insufficiency (CVI) among patients in CEAP classes C3-C4.

Methods: A comprehensive multicenter retrospective analysis was conducted, including patients aged 18-70 with CEAP class C3-C4 CVI. Participants were divided into two groups: one receiving 500 mg of calcium dobesilate twice daily and the other 1000 mg twice daily. Patient progress was monitored using the Global Index Score, CIVIC-20 Score, and precise measurements of ankle and calf circumferences over a 12-month period.

Results: The higher dosage group (1000 mg twice daily) showed significant improvements in both symptom relief and edema reduction. Ankle circumference reduced notably at 6 months, while calf circumference and overall quality of life, measured by the Global Index Score, showed significant improvement by 12 months compared to the lower dosage group.

Conclusions: Higher doses of calcium dobesilate markedly enhance the management of CVI symptoms and reduce edema more effectively than lower doses, particularly in patients with advanced CVI. These findings support the use of higher dosages for optimal treatment, though further research is needed to fully evaluate long-term safety.

Background: This study aimed to evaluate the variability in practice patterns associated with the performance of duplex ultrasound (DUS) for venous insufficiency.

Methods: Sonographers participated in a survey regarding patient positioning and method of augmentation as well as the availability of ergonomic equipment for DUS.

Results: DUS was performed in RT position by 41% of sonographers versus standing position in 40%. In 18% of laboratories, if the RT position did not demonstrate reflux, the study was repeated in the standing position. An automated cuff inflation device was used as the primary method of augmentation in only 22% of practices.

Conclusions: There is a lack of standardization for the performance parameters of patient position and method of augmentation in VDU, which may lead to variation in the results between sonographers and institutions.

Methods: The venous drainage of the breasts is described and the cerebrospinal venous systems (CSVS) of six patients with treated breast cancer were assessed using duplex ultrasound to measure venous blood volume flows in the neck veins.

Results: All six patients with breast cancer showed evidence of cerebrospinal venous obstruction (CSVO). Further, all six demonstrated collateral flow in the erect position in the internal jugular vein on the same side as the diagnosed breast cancer.

Conclusion: There is an indication for a well-designed case-control study using the duplex ultrasound neck vein examination, comparing patients treated for breast cancer with healthy women.

Objectives: Post-thrombotic syndrome (PTS) is a frequent and important consequence of deep vein thrombosis (DVT) for Behcet`s disease (BD) patients. Although various clinical scales are used to diagnose PTS, Villalta scale was accepted as the standard tool to diagnose and grade the severity of PTS. Poor quality of life (Qol) in the general population was defined for patients with PTS, however, studies in BD patients with PTS is limited. Our aim was to compare the performance of different scales to assess venous disease in BD patients with a history of DVT and to assess the relationship with quality of life.Methods: Patients with BD (n = 194, M/F:157/37, age:39.1 ± 9.5 years) with a DVT history were investigated. Villalta, VCSS,CEAP scale and SF 36,Veines scales were used to assess venous disease and QoL respectively.Results: Among BD patients, 120 (61.9 %) patients were classified as having PTS by Villalta and of patients 18% had severe PTS. Half of patients with CEAP score <4 were classified as having PTS. Also, 42% of patients with CEAP>4 and almost two third of VCSS classified severe CVD patients was grouped in severe PTS by Villalta scale. VCSS and Villalta classified PTS patients had decreased disease specific and general Qol scores compared to the patients without PTS. Also, severe PTS group (by VCSS) had decreased veines QoL scores and PCS compared to mild/moderate group.Conclusion: BD patients with DVT have a high risk of PTS. Our results show that both Villalta scale and VCSS should be used to assess venous disease BD patients with DVT. However, VCSS classified severity of PTS can show better correlation with venous disease -specific QoL.

Objectives: This systematic review aimed to assess the efficacy of Leukocyte- and Platelet-Rich Fibrin (L-PRF) for the treatment of vascular leg ulcers. Method: Following PRISMA guidelines, a literature search was done for studies where L-PRF was used to treat vascular leg ulcers. Results: Among six included articles, a total of 76 venous leg ulcers were treated with L-PRF. None of the studies included ulcers of arterial or lymphatic origin. Fifty-seven (75.0%) of the venous ulcers completely healed at end of follow-up. Mean time to complete healing was 6.7 weeks (SD = 5.0). All non-healed ulcers showed an important reduction in wound area. No adverse effects related to L-PRF therapy were reported. Conclusions: The results suggest that L-PRF could be a safe, simple to use and effective therapeutic option for the treatment of venous leg ulcers, however, caution is advised as the results are based on small sample sizes.