s-5682 and Chronic-Disease

The author characterizes the edema as an important quantitative objective measure of severity for chronic venous diseases in both early and advanced stages. The problems of edema assessment methods and the importance of its management in clinical practice are discussed. The results of studies on the use of micronized purified flavonoid fraction (MPFF, Detralex) for edema syndrome coping are presented.

Topics: Chronic Disease; Diosmin; Drug Combinations; Edema; Hesperidin; Humans; Prognosis; Severity of Illness Index; Venous Insufficiency

Daflon 500 mg consists of 450 mg diosmin and 50 mg flavonoid expressed as hesperidin. The authors describe its effects on the microcirculation in chronic venous insufficiency: improvement of venous tone, inhibition of prostaglandin synthesis, protection against free radicals, activation of the complement system, and increased lymphatic drainage. The authors summarize studies of its therapeutic efficacy in reducing venous capacitance, distensibility, and emptying time; reducing capillary permeability; and increasing capillary resistance.

Topics: Animals; Chronic Disease; Diosmin; Drug Combinations; Flavonoids; Hesperidin; Humans; Venous Insufficiency

The aim of this clinical study was to compare the degree of postoperative pain (VAS--10 cm, quality of life questionnaire CIVIQ and patient diary) between two groups of patients: patients treated with Detralex 14 days before and 14 days after the stripping of greater saphenous vein (GSV) and patients not treated with Detralex. In addition, the two groups were also compared for the incidence of symptoms associated with chronic venous insufficiency (CVI) (using the VAS scale: edema, tired and heavy legs, cramps, itching sensation), size of hematoma, use of analgesics and overall efficacy of the treatment. Clinical study included 181 patients from 15 medical centers throughout the Czech Republic. High ligation and partial stripping of greater saphenous vein on one lower extremity was performed in all patients (short stripping from groin to knee). Patients were randomly assigned in two groups: patients treated with Detralex (92) and patients not treated with Detralex (89). Patients in the first group were treated with Detralex for the period of 1 month. Degree of pain and patient's health condition were evaluated by the physician during D-14 (14 days prior to the surgery), D7 and D14 (7 and 14 days after the surgery) visits using the 10-cm visual analog scale VAS. The results indicate that Detralex reduced the intensity of postoperative pain, which resulted in decreased consumption of analgesics. Hematoma was smaller in patients already using Detralex 14 days prior to the scheduled stripping procedure. These patients also showed significant improvement of CVI symptoms and the quality of life of patients with CVI. High quality venoactive drugs administered 14 days prior to the surgery improve postoperative course in patients indicated for surgical treatment of varices.

Topics: Adolescent; Adult; Chronic Disease; Diosmin; Drug Combinations; Hesperidin; Humans; Middle Aged; Pain Measurement; Pain, Postoperative; Postoperative Complications; Quality of Life; Saphenous Vein; Vascular Surgical Procedures; Venous Insufficiency

Fourteen patients with chronic venous insufficiency (CVI) of the lower extremities, class 0-4 according to the CEAP (1995) were examined for microcirculation (MC) and effect of detralex, using biomicroscopy of the conjunctival vessels and capillaroscopy of the nail matrix, with detailed computed morphometry. In 7 patients, CVI was associated with truncal arterial hypertension and in 5 with type 2 diabetes mellitus. It has been established that in CVI patients, there were remarkable disorders of MC and regional circulation. In addition to regression of the clinical manifestations of CVI, administration of detralex given in courses to 12 patients noticeably refined both regional circulation in the lower extremities and systemic MC, marked by abatement of perivascular edema, an increase in the number of the functioning microvessels and flow acceleration in them. Also, there was marked the lowering of intramuscular red blood cell aggregation.

Topics: Chronic Disease; Diosmin; Drug Combinations; Erythrocyte Aggregation; Female; Hesperidin; Humans; Male; Microcirculation; Middle Aged; Severity of Illness Index; Varicose Veins

76 patients with severe venous insufficiency (CVI) entered the study. All the patients received 500 mg of Detralex twice daily for 2 months. The drug was well tolerated and relieved CVI symptoms in the majority of cases.

Topics: Chronic Disease; Diosmin; Drug Combinations; Flavonoids; Hesperidin; Humans; Tablets; Time Factors; Venous Insufficiency

A randomized, double-blind, multicenter trial was performed to study the pharmacodynamic and clinical activities of Daflon 500 mg,* in comparison with a nonmicronized diosmin. Daflon 500 mg is a micronized purified flavonoidic fraction consisting of 450 mg of diosmin and 50 mg of hesperidin per tablet, which has been micronized in order to ensure a better gastrointestinal absorption. Ninety patients with chronic venous insufficiency of the lower limbs, stabilized for one year, entered the study. They received either two tablets of Daflon 500 mg or an equivalent dose of nonmicronized diosmin in two divided doses each day during two months. The following parameters were studied: functional clinical symptoms in the lower extremities, ankle circumference measurement, strain gauge plethysmographic parameters with 20, 40, and 60 mmHg venous occlusion, and clinical and biochemical acceptability. Statistically significant changes were obtained in both groups of patients in comparison with baseline values. However, the improvements in all clinical symptoms and plethysmographic parameters (maximum increase of venous volume at 60 mmHg and total time for emptying) were significantly better with Daflon 500 mg than with nonmicronized diosmin. The clinical and laboratory acceptability was similar in both groups. However, the percentage of satisfied patients was 95% in the Daflon 500 mg group, versus 80% in the nonmicronized diosmin group (p < 0.01). In conclusion, the pharmacodynamic and clinical activities of Daflon 500 mg are superior to those of an equivalent dose of nonmicronized diosmin and demonstrate the therapeutic advantage of a micronized formulation in the treatment of chronic venous insufficiency.

Topics: Adult; Chronic Disease; Diosmin; Dosage Forms; Double-Blind Method; Drug Combinations; Female; Flavonoids; Hesperidin; Humans; Male; Middle Aged; Patient Satisfaction; Plethysmography; Venous Insufficiency

Hemorrhoidal disease (HD) is a trophic disorder of the anal canal characterized by recurrent, self-resolving acute episodes. The author reports the results of a double-blind, placebo-controlled trial of the efficacy of Daflon 500 mg in the treatment of acute and chronic symptoms of hemorrhoids. One hundred and twenty outpatients (54 men, 66 women) suffering from an acute episode of HD during the previous two months were included. They received Daflon 500 mg (group D, n = 60) or placebo (group P, n = 60) two tablets daily for two months. The patients were examined at entry (T0) and at two months (T2). At T0, the two groups did not differ in terms of age, sex, weight, height, history of symptoms of HD; 7 patients were excluded from analysis because of treatment failure (group D, n = 2; group P, n = 3), or lost to follow-up (group P, n = 2). In group D, 40% of patients had an attack during the trial with a mean duration of 2.6 days and a mean severity of 1.1 scored on a scale from 1 to 3. These values were significantly different (P < 0.01) from the corresponding values in the P group: 70%, 4.6 days and 1.6 respectively. Each symptom and sign was scored on a scale of severity. The overall symptom score, scored from 0 to 15, decreased from 6.6 (group D) and 6.1 (group P) (NS) to 1.1 and 4.0 respectively (P < 0.01) at the end of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Acute Disease; Chronic Disease; Diosmin; Double-Blind Method; Drug Combinations; Female; Flavonoids; Hemorrhoids; Hesperidin; Humans; Male; Middle Aged

Sclerotherapy is a common technique for the removal of intradermal veins. This study examined the rationale for prescribing micronized purified flavonoid fraction (MPFF) in clinical, etiological, anatomic, pathophysiologic (CEAP) class C1 patients with dilated intradermal veins scheduled for sclerotherapy.. In a national, multicenter, observational program, physicians recruited CEAP C1s patients scheduled for sclerotherapy. The decision to prescribe adjuvant MPFF (1000 mg/day for 6 weeks beginning 2 weeks before sclerotherapy) was made according to usual practice. Disease severity and treatment outcomes were assessed at baseline and 4 weeks post-sclerotherapy using a visual analog scale (VAS) as well as quality-of-life (CIVIQ-14) and patient satisfaction (Darvall) questionnaires.. A total of 70 physicians recruited 1150 patients: 1071 (93%) women, 79 (7%) men. Mean age (± SD) was 40.7 ± 10.7 years (range 18-74) and mean body mass index was 23.6 ± 3.3 kg/m. Resolution of venous symptoms post-sclerotherapy was greater in patients treated with MPFF compared with those undergoing sclerotherapy alone, supporting the rationale for use of MPFF in patients undergoing sclerotherapy.. Servier.

Topics: Administration, Oral; Adult; Chronic Disease; Diosmin; Drug Combinations; Edema; Female; Flavonoids; Hesperidin; Humans; Male; Middle Aged; Pain; Pre-Exposure Prophylaxis; Quality of Life; Sclerotherapy; Surveys and Questionnaires; Telangiectasis; Treatment Outcome

This study was conducted to determine the frequency of complaints in a cohort of patients with symptomatic hemorrhoidal disease (HD) treated with micronized purified flavonoid fraction (MPFF, Detralex). MPFF was selected for conservative treatment in this population owing to its proven effects on hemorrhoidal symptoms in a large number of patients.. This multicenter, non-interventional study was part of the international CHORUS survey (Chronic venous and HemORrhoidal diseases evalUation for improvement of Scientific knowledge), conducted in nine centers in different regions of Russia with the participation of 80 coloproctologists. The study enrolled consecutive patients with complaints of hemorrhoids. All were prescribed MPFF-based conservative treatment. The effect of treatment on HD clinical signs and symptoms was assessed at two follow-up visits performed 5-7 days and 25-30 days after enrollment. Surgical and minimally invasive treatment could be performed from day 7 onwards if required.. A total of 1952 patients were enrolled. Over the entire period of observation, MPFF-based conservative treatment was effective in 1489 (76.3%) patients in eliminating the main clinical manifestations of disease, i.e., bleeding and prolapse of internal nodes. Invasive treatment was performed in 68 (3.5%) patients with grade IV hemorrhoids and was combined with MPFF conservative treatment in 395 (20.2%) patients with grades I-III hemorrhoids.. Conservative therapy with MPFF was beneficial for relieving hemorrhoidal symptoms in the majority of patients. MPFF-based treatment was most effective in patients with grade I and II hemorrhoids before irreversible degenerative changes in ligaments of the hemorrhoidal plexuses have occurred. It was also beneficial in preventing disease relapse in patients with more advanced HD and for promoting optimal conditions in the postoperative period.. Servier.

Topics: Adult; Chronic Disease; Conservative Treatment; Diosmin; Drug Combinations; Female; Flavonoids; Hemorrhage; Hemorrhoids; Hesperidin; Humans; Male; Middle Aged; Russia; Secondary Prevention; Severity of Illness Index; Symptom Assessment; Treatment Outcome

The work presents an analysis of results of conservative treatment of 48 patients aged from 32 through 76 years having postthrombophlebitic syndrome with symptoms of chronic venous insufficiency. The system of complex pharmacotherapy included phlebothropic medicines of flavonoid series (detralex) and of synthetic origin (tribenosid). The course of treatment was 2-3 months. Long-term results of the treatment were followed-up during the period from 6 months to 2 years in 44 patients. The complex treatment resulted in reliably less degree of clinical manifestations (chronic venous insufficiency). Recurrence of trophic ulcers appeared in 6 patients.

Topics: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Blood Flow Velocity; Blood Viscosity; Chronic Disease; Diosmin; Drug Combinations; Drug Therapy, Combination; Female; Follow-Up Studies; Foot Ulcer; Glycosides; Hesperidin; Humans; Leg; Male; Middle Aged; Phlebography; Recurrence; Severity of Illness Index; Thrombophlebitis; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Duplex; Venous Insufficiency

To verify incidence of risk factors of chronic venous insufficiency (CVI) of the lower limbs and efficacy of outpatient treatment.. A total of 4388 patients were examined by questioning and examination of the lower limbs. 1209 patients with CVI stages C1, C2 and C3 were included in the study. They received recommendations to use elastic compression, topic modalities, physiotherapy. Patients of the study group were given, in addition, detralex for 8 weeks.. Characteristic symptoms of CVI were seen in 68% males and 84% females but only 17.5 and 20%, respectively, had complaints. The risk was highest in history of CVI in the patient's mother, sitting or standing job, hard physical labour, obesity and constipation, two or more labours in women. The effect was achieved in the detralex group.. Many outpatients had symptoms of chronic venous insufficiency but had no complaints. Detralex therapy proved highly effective in outpatient practice.

Topics: Adolescent; Adult; Age Factors; Aged; Bandages; Chronic Disease; Constipation; Diosmin; Drug Combinations; Exercise Therapy; Female; Hesperidin; Humans; Incidence; Leg; Male; Middle Aged; Obesity; Risk Factors; Sex Factors; Treatment Outcome; Venous Insufficiency