1,721,019 research outputs found
Elevare per alleviare - Infermieristica vascolare basata sull'evidenza
Full text linkBackground: Venous return in the circulatory system of lower limbs results from the interaction of several mechanisms and reflects the balance between blood inflow and outflow. Blood outflow improves during the lying position especially with leg elevation both in patients with chronic venous disease (CVD) and in healthy subjects in sedentary settings with short-term immobilization. This study evaluated the level of comfort of hospital inpatients, without CVD, lying with a moderate leg elevation during hospital stay.
Methods: This was a clinical trial examining 60 consecutive patients referred to vascular surgery, cardiac surgery, and nephrology units. After inclusion, patients were randomly assigned to two groups: A (leg elevation) in which patients were made to lie in the hospital bed with moderate elevation of the legs, and B (no leg elevation) in which patients were made to lie in the hospital bed without leg elevation.
Results: The whole population consisted of 40 patients undergoing leg elevation (group A) and 20 without leg elevation (group B). During each day of hospitalization, measurements such as ankle and calf circumference, heart rate, blood pressure, and body temperature were collected. Subjective data such as perceived heaviness in the lower limbs, comfort perception and hours of sleep were also collected. In this study, patients of group A recorded a decrease in calf and ankle circumference (delta in ankle and calf circumference (difference between end of study visit and baseline visit) were significantly decreased in group A vs group B (p< 0.001 for both sides), and patients perceived less leg heaviness and even reported more leg comfort compared to patients of Group B (p< 0.001)). Among patients of group A, the bigger advantage in terms of comfort perception was recorded in patients with 15° leg elevation.
Conclusion: Moderate leg elevation during hospital stay seems to effectively improve leg comfort in hospitalized patients
Environmental Pollution and Peripheral Artery Disease
Full text linkPeripheral artery disease (PAD) of the lower limbs represents one of the most important clinical conditions among vascular disease and can negatively impact quality of life of affected patients, representing also an important socioeconomic burden. Several risk factors predispose to PAD and its complications. Nevertheless, the role of pollution in this context has not been fully evaluated and this article explored the most updated information on epidemiology and environmental pollution in order to hypothesize the possible contribution of air pollution in the onset of PAD. Pollution is an important problem for the global community and has harmful effects on human health and cardiovascular system, and, specifically, particulate matter 10 (PM10) was found significantly associated with PAD
Cardiovascular disease as a biomarker for an increased risk of COVID-19 infection and related poor prognosis
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Sex and the veins. A cross-sectional analysis on sexual dysfunction in patients with chronic venous disease
Full text linkBackground: This study aimed to investigate the presence of sexual dysfunction (SD) in patients
with Chronic Venous Disease (CVD) and if CVD treatments may have an impact on SD evolution
in these patients.
Methods: Inclusion criteria were patients of both sexes and genders, with minimum age of 18, with
first diagnosis of CVD. Exclusion criteria were presence of known sexual dysfunction of organic
origin, arterial system diseases, malignancies and endocrine system diseases. Included patients
were administered the ASEX (Arizona Sexual Experience) questionnaire that was administered at
the moment of study inclusion (T0), and for patients that resulted affected from sexual
dysfunction, were administered also, after CVD treatments at 6 months (T1) and after 12 months (T2).
Results: A total of 649 patients with CVD were recruited. After the administration of the ASEX
questionnaire, 122 patients (18.8 %) resulted affected from SD. Female sex, C3–C6 clinical stages,
and the presence of Coronary Artery Disease (CAD), hypertension, and hyperlipidemia were more
associated with the presence of SD. SD improved in all patients’ population, especially after CVD
treatment at T2.
Conclusions: CVD patients may experience SD, especially in female sex, in more advanced diseasestages. SD in CVD patients appears to improve after adequate CVD treatment
Infection, infectious agents and vascular disease
No full textBackground: Infectious agents may be involved in the pathogenesis of vascular disease and related complications. The aim of this review is to analyze the most relevant information on the common infections related to vascular disease, discussing the main pathophysiological mechanisms.
Methods: In the current review, the most important evidences on the issue of infections and vascular disease were searched on Medline, Scopus, and ScienceDirect database.
Results: Among infectious agents, herpesviruses, parvovirus B19, hepatitis viruses, human immunodeficiency virus, severe acute respiratory syndrome coronavirus 2, treponema pallidum, mycobacterium tuberculosis, pseudomonas aeruginosa, staphylococcus aureus, and candida albicans seem to particularly related to vascular disease.
Conclusion: Infectious agents may affect vessel's homeostasis and functionality, both on the arterial and venous side, by means of several pathophysiological mechanisms such as dysregulation in vasomotor function, thromboembolic complications, initiation and progression of atherosclerosis, alteration of perivascular adipose tissue, recruiting inflammatory cells and molecules
Percutaneous and surgical femoral access for thoracic endovascular aortic repair using local anesthesia
Full text linkBaCKgrOuND: Nowadays, thoracic endovascular aortic repair (TEVar) is frequently the choice for treatment of thoracic aortic disease because of its less invasiveness. generally, this technique is performed with surgical femoral access with general and epidural anesthesia or with a local anesthesia without spinal catheterization, but there is evidence in literature that suggests the validity of percutaneous approach. The aim of this study is to compare the different techniques according to our personal experience.
METhODS: We retrospectively studied patients affected from thoracic aortic disease, in particular those with thoracic aortic aneurysm (Taa) and acute type B aortic dissection (TBaD), in the period September 2002 to December 2016. The first endpoint was the possibility to achieve the femoral access only by local anesthetic injection, and the second endpoint was the comparison between TEVar with femoral exposure and the percutaneous approach.
rESuLTS: From September 2002 to December 2016 we have selected a cohort of 45 patients affected by thoracic aortic disease, divided in 22 patients with thoracic aortic aneurism (Taa) and 23 patients with acute type B aortic dissection (TBaD). all patients were treated with TEVar undergoing a local anesthesia. Most of the patients were treated with surgical exposition of the common femoral artery while in 10 eligible patients was used the percutaneous approach. in all cases we had correct placement of the endograft, exclusion of false lumen in case of TBaD and absence of primary endoleak in case of Taa after the procedure.
CONCLuSiONS: The use of the local anesthesia, and of the percutaneous approach when possible, have proven to be particularly effective in our casuistr
Bridging Biology and Society: Molecular Insights into Social Determinants of Vascular Disease
No full textBackground: Vascular diseases (VDs)-such as arterial aneurysms, chronic venous disease, and peripheral artery disease-are influenced by a complex interplay of genetic, biological, and social factors. Integrating the assessment of both molecular and social determinants offers a novel framework that connects factors like socioeconomic status, chronic stress, and environmental exposures to the molecular pathways that drive vascular pathophysiology. Methods: This review was conducted searching libraries such as Web of Science, Scopus, MEDLINE and Google Scholar. The aim was to facilitate the analytical integration of studies that highlight the relationship between SDHs and VDs under a biomolecular lens. Results: This review explores how adverse social conditions can initiate inflammation, oxidative stress, epigenetic modifications, and dysregulation of biomarkers such as matrix metalloproteinases, thereby contributing to vascular degeneration and dysfunction. These mechanisms demonstrate how social experiences become biologically embedded, increasing susceptibility to structural vascular changes and impaired circulation. Conclusions: By bridging insights from molecular biology and social science, this approach provides a valuable paradigm for addressing health disparities and advancing prevention and treatment strategies for common vascular diseases
Arteria lusoria dissection with mediastinal hematoma as a complication of a transradial coronary catheterization. Case report and literature review
No full textINTRODUCTION: Aberrant right subclavian artery (ARSA), or arteria lusoria is the most common embro-logic anomaly of the aortic arch. It is generally asymptomatic and incidentally diagnosed during aradiological exam or procedure.PRESENTATION OF CASE: Here, we report a case of ARSA incidentally diagnosed and injured (dissectionwith mediastinal hematoma) during a right transradial coronary angiography in a 83 years old femalepatient. The patient underwent prompt hybrid procedure with the isolation of the right humeral artery from where we positioned a GORE®VIABAHN®9 × 100 mm endoprosthesis. The procedure was successfulwith optimal results at early and long term follow up.DISCUSSION: Sometimes, a dissection of the ARSA may occur, especially for excessive manipulation duringendovascular procedures, and when such complication happens it should be promptly treated as it canbe life-threatening.CONCLUSION: If transradial catheterization during coronary angiography becomes particularly difficult,requires longer time, or the guide wire enters in the descending aorta, particularly attention should bepaid, as dreadful complications such as dissection or lesion may happen and prompt treatment is required
Current knowledge on venous and lymphatic ulcers. A systematic review on evidence-based medicine
No full textINTRODUCTION: Venous leg ulcer (VLU) and lymphatic leg ulcer (LLU) are often encountered in clinical practice, especially in the elderly and they have many important negative consequences on the health status and on the quality of life. Both venous and lymphatic ulcers can be manifested similar aspects, as there is a close anatomical and functional relation between veins and superficial lymphatics that work together to maintain fluid balance in the body. Aim of this review is to explore the common pathophysiological and therapeutic implications in these conditions. EVIDENCE ACQUISITION: We planned to include all the studies dealing with CLUs and LLUs. We excluded all the studies, which did not properly fit our research question, and with insufficient data. EVIDENCE SYNTHESIS: Of the 330 records found, after removing of duplicates, and after records excluded in title and abstract, 54 matched our inclusion criteria. After reading the full-text articles, we decided to exclude 19 articles because of the following reasons: 1) not responding properly to our research questions; 2) insufficient data; the final set included 35 articles. CONCLUSIONS: The abnormalities in the venous and lymphatic system are strictly related, in fact, in advanced chronic venous insufficiency the skin becomes inelastic, stretched, and ischemic with the onset of skin ulceration. On the other side, in lymphedema patients, as long as venous function is preserved, skin ulceration does not occur. Interestingly, impaired lymphatic function is often associated with chronic venous hypertension in severe CVI and in VLU. Actually, compression therapy acting contemporarily on both systems represent the gold standard for the management of skin ulceration
Social capital in chronic disease: an ethnographic study
Full text linkChronically ill conditions are particularly difficult to manage because of their impact both on the social and on the corporal sphere to such an extent as to involve a series of problems that negatively alter the quality of life of affected patients. Chronicity has also a considerable ef-fect on social capital. In the current literature, it is known that social capital may contribute to a range of advantages to people health. Chronic Venous Disease (CVD) includes several pathologi-cal alterations of the venous system of the lower limbs that cause a wide range of symptoms and signs. The aim of this study is to explore, with a qualitative approach, the dynamics of social cap-ital within people's experience of CVD and describe the roles of family and friends and the health care system. The method used is based on face-to-face semistructured interviews was performed, following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Six-teen patients were included: 11 women and 5 men. The results obtained are completely in line with the current literature, which shows a certain difficulty in terms of daily activities, pain management; work-related difficulties; non-coverage of healthcare costs for medications and drugs prescribed. In the context of social capital, the bonding social capital of the patients inter-viewed was more positively perceived in the role of CVD management than by the patients' fami-lies. Another interesting result concerns the total absence of knowledge of patient associations with CVD. Thus, alongside the biographical destruction that CVD entails, there is evidence of the scarce relevance and presence of health policies capable of improving the quality of life of these people not only from a social and medical point of view but also from an economic point of vie
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