Ticlopidine in the Treatment of Multiple Atherosclerotic Arteriopathy: a Strain Gauge Plethysmography and Döppler Spectrum Analysis Evaluation

The effect of ticlopidine was compared with flunarizine in patients with iliac–femoral and / or femoral–popliteal arteriosclerotic arteriopathy accompanied by lesions of the cervical arteries of no haemodynamic significance. In the lower limbs, plethysmography (strain gauge measurements) and Döppler ultrasonography integrated by spectral analysis of the cervical arteries showed qualitative and quantitative improvements of the regional haematic flow. Side-effects were negligible which suggests that ticlopidine is useful in the treatment of multiple arteriosclerotic arteriopathy.

Il trattamento domiciliare della TVP

Calf veins thrombosis: optimal duration of treatment

Trattamento delle manifestazioni vascolari nella Sclerosi Sistemica e qualità della vita: nuovo protocollo

Residual vein thrombosis to establish duration of anticoagulation after a first episode of deep vein thrombosis: the Duration of Anticoagulation based on Compression UltraSonography (DACUS) study

Abstract Residual vein thrombosis (RVT) indicates a prothrombotic state and is useful for evaluating the optimal duration of oral anticoagulant treatment (OAT). Patients with a first episode of deep vein thrombosis, treated with OAT for 3 months, were managed according to RVT findings. Those with RVT were randomized to either stop or continue anticoagulants for 9 additional months, whereas in those without RVT, OAT was stopped. Outcomes were recurrent venous thromboembolism and/or major bleeding. Residual thrombosis was detected in 180 (69.8%) of 258 patients; recurrent events occurred in 27.2% of those who discontinued (25/92; 15.2% person-years) and 19.3% of those who continued OAT (17/88…

The Effects of Prostaglandin E-1 in Patients with Intermittent Claudication

Aim of the study is to evaluate the effects of Prostaglandin E-1 (PGE-1) in patients with peripheral arterial disease (PAD) at the 2nd b stage Fontaines classification. The study, controlled, single blinded, enrolled 123 patients with intermittent claudication that were randomised in two groups; the first group received a treatment with PGE-1 while the second one received a pentoxifylline-buflomedil association by venous infusion. We evaluated: Pain Free Walking Distance (PFWD), Maximum Walking Distance (MWD), Rest Flow (RF), Peak Flow (PF), Basal (BVR) and Minimal Vascular Resistance (MVR) with a strain gauge plethysmograph, Resting Flow (RF), Peak Flow (PF), time to reach the Peak Flow (t…

Effects of Physical Exercise on Inflammatory Markers of Atherosclerosis

It is well established that physically fit individuals have a reduced risk of developing CVD (cardiovascular disease) and other age-related chronic disorders. Regular exercise is an established therapeutic intervention with an enormous range of benefits. Chronic low-grade systemic inflammation may be involved in atherosclerosis, diabetes and in pathogenesis of several chronic pathological conditions; recent findings confirm that physical activity induces an increase in the systemic levels of a number of cytokines and chemokines with anti-inflammatory properties. The possibility that regular physical exercise exerts anti-inflammation activity, being the interaction between contracting muscle…

Metabolic therapy in the treatment of chronic critical limbs ischemia: the L-propionyl-carnitine enhances the effects of PGE-1

Serial 2-Point Ultrasonography Plus D-Dimer vs Whole-Leg Color-Coded Doppler Ultrasonography for Diagnosing Suspected Symptomatic Deep Vein Thrombosis

Context Patients with suspected deep vein thrombosis ( DVT) of the lower extremities are usually investigated with ultrasonography either by the proximal veins ( 2-point ultrasonography) or the entire deep vein system ( whole- leg ultrasonography). The latter approach is thought to be better based on its ability to detect isolated calf vein thrombosis; however, it requires skilled operators and is mainly available only during working hours. No randomized comparisons are yet available evaluating the relative values of these 2 strategies. Objective To assess if the 2 diagnostic strategies are equivalent for the management of symptomatic outpatients with suspected DVT of the lower extremities.…

Antiplatelet treatment in ischemic stroke treatment.

Antiplatelets represent a diverse group of agents that share the ability to reduce platelet activity through a variety of mechanisms. Antithrombotic agents are effective in the secondary prevention of ischemic strokes. Most strokes are caused by a sudden blockage of an artery in the brain (called an ischaemic stroke) that is usually due to a blood clot. Immediate treatment with antiplatelet drugs such as aspirin may prevent new clots from forming and hence improve recovery after stroke. Several studies have evaluated the role of one antiplatelet agent, aspirin, in reducing stroke severity. The International Stroke Trial (IST) of 20,000 patients with acute stroke from other countries. In thi…

Peso dei fattori di rischio nell’evoluzione dell’aterosclerosi preclinica

Asymptomatic carotid lesions and aging: role of hypertension and other traditional and emerging risk factors

ASYMPTOMATIC CAROTID LESIONS AND AGING: ROLE OF HYPERTENSION AND OTHER TRADITIONAL AND EMERGING RISK FACTORS BACKGROUND: We evaluated the prevalence of intima-media thickening (IMT) and asymptomatic carotid plaque (ACP) in a group of subjects with or without traditional and/or emerging risk factors (RF). METHODS: There were 631 subjects (313 male and 318 female) aged between 19 and 97 years, asymptomatic for cerebro- and cardiovascular diseases. The following measurements were used: anamnesis, physical examination, height and sitting blood pressure. Biochemistry variables were also considered: total cholesterol, HDL-C, LDL-C, triglycerides, fibrinogen, high sensitive C-reactive protein, IgG…

Immunohistochemical expression of iNOS and eNOS in the venous ulcers related to chronic venous insufficiency (CVI).

Residual vein thrombosis estabilishes the optimal duration of oral anticoagulants for the treatment od DVT

Sodium thiosulfate not always resolves calciphylaxis: an ambiguous response

Calciphylaxis is a severe “vascular ossification–calcification,” associated with a very high mortality rate that involvesarterial wall, venular wall, and nerves resulting in ischemia and necrosis of skin, subcutaneous fat, visceral organs,and skeletal muscles. Sodium thiosulfate has recently been used as a novel treatment option for calciphylaxisbecause of its dual role as an antioxidant and a chelator. Multiple case reports demonstrated that such therapy hasresulted in pain relief and healing of skin ulceration. We report a case of calciphylaxis of large severity that had anambiguous response to sodium thiosulfate treatment (improvement of symptomatology and skin lesions, improve-ment of b…

Ischemia critica cronica e vasculopatia ischemica polidistrettuale

Calf vein thrombosis: optimal duration of tretment

Residual vein thrombosis assessment estabilishes the optimal duration of oral anticoagulants in patients with idiopatic or provoked deep vein thrombosis. a randomized, controlled trial

SUPERFICIAL VENOUS THROMBOSIS: ROLE OF GENETIC RISK FACTORS ON SPREADING TO DEEP VEINS

La terapia metabolica nel trattamento dell'ischemia critica cronica degli arti inferiori: la L-propionilcarnetina potenzia gli effetti della PGE-1

Trombosi venosa superficiale ed estensione al circolo profondo: ruolo dei fattori di rischio genetici

Calf vein thrombosis: optimal duration of treatment

NO and Chronic Venous Insufficiency (CVI): Immunohistochemical Evaluation of iNOS and eNOS Isofroms in the Venous Ulcers. Clinical and Therapeutical Possible Implications

Iloprost treatment in patients with Raynaud's phenomenon secondary to systemic sclerosis and the quality of life: a new therapeutic protocol

Objectives: to evaluate the clinical efficacy and the effects on the quality of life of Iloprost, a prostacyclin analogue, used, according to a new protocol, in patients with Raynaud’s phenomenon secondary to Systemic Sclerosis. Methods: in this randomized study we treated 30 patients with Iloprost given by intravenous infusion, at progressively increasing doses (starting from 0.5 ng/Kg/min up 2 ng/Kg/min) over a period of 6 hours a day for ten days in two consecutive weeks, with repeated cycles at regular intervals of three months for 18 months. The results were compared with those obtained in 30 other patients, who had received the same drug but with different posologic schemes. Results: …

Response to letter by Drs. Mohammed Abbas, Maria Sessa, and Francesco Corea

Modello di percorso diagnostico e terapeutico per la trombosi venosa superficiale

Residual Vein Thrombosis Assessment Establishes the Optimal Duration of Oral Anticoagulants in Patients with Idiopathic or Provoked Deep Vein Thrombosis: a Randomized, Controlled Trial

Immunohistochemical expression of iNOS and metalloproteinases MMP2 and MMP9 in abdominal inflammatory aortic Aneurysms

Moderno approccio alla trombosi venosa superficiale

Residual vein thrombosis assessment establishes the otpimal duration of oral anticoagulants in patients with idiopathic or provoked deep vein thrombosis

METABOLIC THERAPY IN THE TREATMENT OF CHRONIC CRITICAL LIMBS ISCHEMIA OF THE LOWER LIMBS. THE L-PROPIONYL-CARNITINE ENHANCES THE EFFECTS OF PGE-1

Residual vein thrombosis assessment estabilishes the optimal duration of oral anticoagulants in patients with idiopatic or provoked deep vein thrombosis

Superficial venous thrombosis and spreading to deep veins: role of genetic risk factors for venous thromboembolism

Asymptomatic Carotid Lesions and Aging: Role of Hypertension and Other Traditional and Emerging Risk Factors

Background We evaluated the prevalence of intima-media thickening (IMT) and asymptomatic carotid plaque (ACP) in a group of subjects with or without traditional and/or emerging risk factors (RF). Methods There were 631 subjects (313 male and 318 female) aged between 19 and 97 years, asymptomatic for cerebro- and cardiovascular diseases. The following measurements were used: anamnesis, physical examination, height and sitting blood pressure. Biochemistry variables were also considered: total cholesterol, HDL-C, LDL-C, triglycerides, fibrinogen, high sensitive C-reactive protein, IgG antibodies for Helicobacter pylori (HP), cytotoxic HP, cytomegalovirus and Chlamydia pneumoniae . Finally, an …

The supraventricular tachycardias: Proposal of a diagnostic algorithm for the narrow complex tachycardias

AbstractThe narrow complex tachycardias (NCTs) are defined by the presence in a 12-lead electrocardiogram (ECG) of a QRS complex duration less than 120ms and a heart rate greater than 100 beats per minute; those are typically of supraventricular origin, although rarely narrow complex ventricular tachycardias have been reported in the literature.As some studies document, to diagnose correctly the NCTs is an arduous exercise because sometimes those have similar presentation on the ECG. In this paper, we have reviewed the physiopathological, clinical, and ECG findings of all known supraventricular tachycardias and, in order to reduce the possible diagnostic errors on the ECG, we have proposed …

Ischemia critica e connettiviti: presupposti fisiopatologici per un protocollo di trattamento

Aspetti fisiopatologici dell'ulcera venosa

The effects Prostaglandine E-1 in patients with intermittent claudication

Superficial venous thrombosis: role of genetic risk factors on spreeding to deep veins

Superficial venous thrombosis: Prevalence of common genetic risk factors and their role on spreading to deep veins

Introduction. Superficial venous thrombosis (SVT) has been considered for a long time a limited clinical condition with a low importance, but this approach has changed in recent years, when several studies demonstrated spreading to deep veins occurring from 7.3 to 44%, with high prevalence of pulmonary embolism . Materials and Methods. To evaluate the prevalence of genetic risk factors for VTE in patients suffering from SVT on both normal and varicose vein, and to evaluate their role on spreading to deep veins, we studied 107 consecutive outpatients with symptomatic SVT. Ultrasound examination was performed, and the presence of FV Leiden, Prothrombin G20210A mutation, MTHFR C677T mutation w…

Subclavian Stenosis/Occlusion in Patients with Subclavian Steal and Previous Bypass of Internal Mammary Interventricular Anterior Artery: Medical or Surgical Treatment?

There are only a few published studies on the association between subclavian steal syndrome and ischemic heart disease. The objective of this report is to evaluate the efficacy of subclavian stenoocclusion treatment in patients with subclavian steal syndrome (SSS) and previous cor- onary bypass. Over the last 8 years we observed 207 patients who underwent left internal mammary artery–intraventricular artery (LIMA–IVA) bypass graft. Of these, 31 patients were affected by steno-occlusion of the homolateral subclavian artery. Ten patients (group 1) showed latent vertebral-SSS and were pharmacologically treated. Seven patients (group 2) had an intermittent vertebral-SSS; four patients were trea…

Hypertension and peripheral arterial hemodynamics.

Sixty uncomplicated hypertensive patients (30 stable and 30 borderline) were studied, by strain gauge plethysmography, in comparison with 25 normotensive subjects, in order to evaluate the arterial hemodynamics of the lower limbs in essential hypertension and to verify the different pattern in borderline and in stable hypertensives. Resting blood flow, even if slightly decreased in hypertensive groups, did not show significant differences in its mean values; peak flow, instead, was reduced proportionally to the severity of hypertension in all the hypertensive patients, but only in the stable hypertensives was it statistically significant. Minimal vascular resistance showed a similar behavi…

Stress ossidativo in pazienti con sclerodermia: effetti dell’iloprost.

Effetti dell’iloprost sulla disfunzione leucocitaria nella sclerodermia.

TROMBOSI PROFONDA SUPERFICIALE ED ESTENSIONE AL CIRCOLO PROFONDO: RUOLO DEI FATTORI DI RISCHIO GENETICI

Absence of residual vein thrombosis after an episode of idiopatic deep vein thrombosis: short-term anticoagulation is safe. The extended DACUS Study

Abstract Background. The optimal duration of Oral Anticoagulant Therapy (OAT) for Deep Vein Thrombosis (DVT) can be tailored by Residual Vein Thrombosis (RVT) (Siragusa S et al. Blood2003;102(11):OC183), a marker able to assess the individual risk for recurrent thrombosis. However, in patients with idiopathic DVT the safety of early interruption of OAT, because of absence of RVT, is still debated. Objective of the study. In the present study, we evaluated the safety of withholding OAT, in patients with idiopathic DVT and without RVT, three months after the index thrombotic episode. Study design. Prospective controlled study with two groups: patients without RVT stopped OAT after 3 months wh…

Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs.

Background. Venous ulcers represent an important medical problem due to their high prevalence and consequent sanitary costs. In this study we evaluated the effect of Prostaglandin E-1 (PGE-1), a drug that improves district ischemia, on the healing of venous ulcers. Methods. We performed a randomized, placebo-controlled, single blind study, in which 87 patients, carriers of venous leg ulcers, homogeneous for dimensions and characteristics, were treated for 20 days an with infusion of Prostaglandin E-1 or placebo, in association with a topic therapy. The dimension and the number of the ulcers were determined at the beginning of the treatment and then every 20 days up to 4 months or until tota…

Effetti emoreologici del trattamento con iloprost in pazienti con fenomeno di Raynaud secondario a sclerodermia.

Pharmacological treatment of patients with chronic critical limb ischemia: L-propionyl-carnitine enhances the short-term effects of PGE-1.

Purpose. To evaluate the therapeutic effects of L-propionyl-carnitine (LPC) in patients with critical limb ischemia (CLI), as defined by the TASC guidelines. Methods. The study, double-blinded, randomised, assessed intravenous infusion of LPC 1.2 g/day in combination with PGE-1, 60 mg/day (LPC group: 37 patients), or PGE-1 only (control group: 38 patients) in a total of 75 patients suffering from CLI. Treatment duration was 20 days. We evaluated rest pain, maximum walking distance (MWD) and skin ulcer size. Results. In both groups we observed a significant reduction in pain score and ulcer size and an increase in MWD. In the patients treated with the combination, the improvement was greater…

Rilievi emoreologici nella sclerosi sistemica.