s-5682 and Varicose-Veins

Topics: Diosmin; Drug Combinations; Flavonoids; Hesperidin; Humans; Sclerotherapy; Varicose Veins; Vasodilator Agents; Venous Insufficiency; Venous Thrombosis

Mineral metabolism is dysregulated within days of acute renal injury in critically ill patients. On univariate analysis, high levels of calcitriol were associated with adverse clinical outcome in AKI. This association was not apparent after adjusting for age and APACHE II. Large controlled studies are needed to confirm these results, and determine if higher 1,25(OH). Los genotipos C/C y C/T en Colombia son tan variables como en otros grupos sanos en otras poblaciones. Los sujetos de nuestra población podrían tener riesgo para el desarrollo de enfermedades asociadas al polimorfismo del genMTHFR y con genotipos de riesgo de presentar toxicidad y efectos adversos del MTX, lo cual sugiere la necesidad de evaluar alternativas terapéuticas con estudios farmacogenéticos.

Topics: Acetaminophen; Administration, Oral; Adolescent; Adult; Advanced Oxidation Protein Products; Aged; Aged, 80 and over; Analgesics, Opioid; Animals; Antibodies, Monoclonal; Antioxidants; ATP Binding Cassette Transporter, Subfamily B, Member 1; Automation; Benzaldehydes; Bromates; Calcifediol; Calcitriol; Carcinoma, Squamous Cell; Catalase; Chromatography, Liquid; Coloring Agents; Cross-Over Studies; Cross-Sectional Studies; Cytochrome P-450 CYP3A; Cytokines; Diabetic Foot; Diabetic Neuropathies; Diagnostic Self Evaluation; Diosmin; DNA Damage; Double-Blind Method; Drug Combinations; Electrodes; Endothelin-1; Esophageal Neoplasms; Esophageal Squamous Cell Carcinoma; Esophagectomy; Exercise; Female; Follow-Up Studies; Gene Expression Regulation; Glutathione; Hesperidin; Humans; Illicit Drugs; Indians, North American; Injections, Intravenous; Interferometry; Interleukin-1beta; Interleukin-6; Interviews as Topic; Ions; Jejunum; Kidney; Leukocyte Count; Lipid Peroxidation; Lithium; Liver; Luminescent Measurements; Male; Mice; Middle Aged; Monocytes; Nanostructures; Oklahoma; Organ Specificity; Oxidative Stress; Oxycodone; Photochemistry; Predictive Value of Tests; Pregnane X Receptor; Preoperative Period; Prescription Drugs; Receptors, Steroid; Reference Values; Reproducibility of Results; Retinoid X Receptor alpha; Retrospective Studies; RNA, Messenger; Rumen; Sheep, Domestic; Shoes; Solar Energy; Superoxide Dismutase; Survival Rate; Tandem Mass Spectrometry; Titanium; Treatment Outcome; Tumor Necrosis Factor-alpha; Varicose Veins; Vitamin D; Water Pollutants, Chemical; Weight-Bearing; Young Adult

Presented in the article are the results of the DECISION multicenter study dedicated io assessment of efficacy and feasibility of using the phlebotropbic drug detralex in the perioperative period in patients undergoing endovascular treatment of lower limb varicose discase. The study comprised a total of 230 patients presenting with chronic venous disease. (CVD) C2-4s according the CEAP classification, each of these had not less than three CVD- related symptoms. All patients were randomly assigned to the Study Group (126 people) and the Control Group (104 subjects). The Study Group patients 2 weeks prior to endovascular treatment and during 4 weeks thereafter took the phlebotrophic drug detralex at a standard daily dose of 1,000 mg. The Control Group patients received conventional compression thernpy using compression bandages or medicinal knitted fabric. The findings of the statistically processed results in the both groups demonstrated a significant decrease in the CVD severity score according to the VCSS scale and an increase in the quality of life parameters according to the disease-specilic questionnaire CIVIQ-14. While so doing, more pronounced dynamics was observed in patients taking detralex during the perioperative period. Besides, there was synergism between the results of the endovascular intervention and therapeutic effects from detralex. Based on the findings obtained in the present study, the authors made a conclusion on feasibility of using the drug detralex as an agent for nonspecific pharmacological protection in endovascular treatment of varicose disease.

Topics: Administration, Oral; Adult; Compression Bandages; Diosmin; Drug Combinations; Endovascular Procedures; Female; Flavonoids; Hesperidin; Humans; Lower Extremity; Male; Middle Aged; Perioperative Care; Protective Agents; Quality of Life; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome; Varicose Veins; Veins

The paper presents the results of DEFANS trial (Detralex - assessment of efficacy and safety for combined phlebectomy). The study enrolled 245 patients with varicose vein disease, who underwent unilateral combined phlebectomy. The main group (n=200) received micronized diosmin (Detralex, 1000 mg/day) for 2 weeks before and 30 days after the procedure; control group (n=45) did not receive Detralex in pre- and postoperative period. Pain severity by 10-point visual analog scale (VAS), an area of subcutaneous hemorrhage in the zone of femoral great saphenous vein resection (by original 12-point scale) and subjective feelings of limb heaviness and fatigability were evaluated 7, 14 and 30 days after the procedure. Subjective symptoms and the area of subcutaneous hemorrhage were significantly lower in the main group, then in control: 7 days after the procedure VAS score was 2.9 and 3.5, respectively; hemorrhage area - 3.4 and 4.6 points, respectively. The same trend was observed for limb heaviness and fatigability, evidencing the better exercise and orthostatic tolerance among patients of the main group in early postoperative period. Quality of life assessment by CIVIQ failed to reveal statistically significant difference between main and control groups in 4-weeks postoperative follow-up. Micronized diosmin in pre- and postoperative period after plebectomy helps to attenuate pain syndrome, to decrease postoperative haematomas and accelerate their resorption, to increase exercise tolerance in early postoperative period.

Topics: Adult; Aged; Arteries; Combined Modality Therapy; Diosmin; Drug Combinations; Female; Hesperidin; Humans; Middle Aged; Varicose Veins; Vascular Surgical Procedures; Veins

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

It has been demonstrated that patients predisposed to the development of varicose veins have an abnormal venous tone, and may have symptoms in the absence of obvious varicosities. It has been suggested that venotonic drugs relieve the symptoms of chronic venous insufficiency by decreasing capillary leakage and improving venous tone. The aim of this study was to determine the effect of Daflon 500 mg in patients with abnormal venous elasticity without varicose veins. Twenty-five healthy female volunteers aged 18-35 were included in the study. They presented with symptomatic varicose veins in one leg and an abnormal elastic modulus without varicosities in the opposite leg. Treatment group: 12 patients received 2 tablets of Daflon 500 mg (1000 mg/day); control group: 13 patients received no treatment. The elastic modulus K was determined using the air plethysmograph. Simultaneous measurements of calf volume changes were made in response to different venous pressures produced by a thigh pneumatic cuff. In the control group K (mean +/- sd) was 10.8 x 10(3) +/- 4.1 x 10(3) N/m2 at the beginning and 10.2 x 10(3) +/- 3.1 x 10(3) N/m2 at the end of the study (P > 0.1). In the treatment group the initial K was 10.2 x 10(3) +/- 3.9 x 10(3) N/m2 and 14.2 x 10(3) +/- 5.1 x 10(3) N/m2 at the end (P < 0.02). The results of the Wilcoxon rank sum test indicated that 4 weeks' therapy with Daflon 500 mg is effective in improving venous tone in patients with symptoms but without varicose veins.

Topics: Adolescent; Adult; Diosmin; Drug Combinations; Elasticity; Female; Flavonoids; Hesperidin; Humans; Varicose Veins; Veins

Abstract The results of 1142 patients treatment for varicose disease of the lower extremities in 2006-2014 yrs were adduced. The patients were divided on 3 groups, depending on the clinical signs severity and method of treatment. There were operated 59 patients, in 65--the proposed scheme of treatment was applied.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angioplasty; Antioxidants; Diosmin; Disease Management; Drug Combinations; Female; Heme; Hesperidin; Humans; Lower Extremity; Male; Middle Aged; Retrospective Studies; Saphenous Vein; Sclerotherapy; Severity of Illness Index; Silicones; Sorption Detoxification; Treatment Outcome; Varicose Veins; Venous Insufficiency

The authors carried out a study aimed at revealing transitory refluxes along the great saphenous vein (GSV) in patients with intracutaneous varicosity, and at investigating the possibility of removing them by means of preparations of micronized purified flavonoid fraction (MPFF). The study included a total of one hundred and forty-seven 21-to-47-year-old (mean age 31±4.4 years) women presenting with cutaneous varicosity (class C1s). The duration of skin manifestations amounted to 9.4±3.9 years (varying from 4 to 24 years). Telangiectasias were present in 69 (46.9%) women, 36 (24.5%) women had reticular varicosity, and 42 (28.6%) a combination thereof. An author-devised test was used with prolonged orthostatic load consisting in carrying ultrasound duplex scanning twice: in the evening after 6 p. m. and in the morning before 10 a.m., assessing the evening and morning parameters of the GSV, as well as the increment of the diameter of the vein at evening measurement as compared with the morning indices. Women with transitory refluxes along the GSV (n=59) underwent treatment with MPFF preparations (Detralex, Servier) during 60 days at a daily dose of 1,000 mg. The morning examination showed that there was no reflux along the GSV. The evening examination revealed refluxes along the GSV of various pattern and extent in 59 (40.1 %). All the 59 patients with evening refluxes presented complaints for increased fatigability, heaviness in the lower limbs by the end of the day. After 2 months of treatment, of the 59 women with initial reflux, 38 (64.4%) patients had no reflux and in 21 (35.6%) the extent of reflux decreased more than twofold. The evening diameter of the GSV decreased from 5.7 mm (95% CI 4.0-7.1) to 5.2 mm (95% CI 5.5-6.5) and the orthostatic gradient decreased from 0.9 mm (95% CD 0.6-1.3) to 0.6 mm (95% CI 0.4-0.8), p=0.000001. The initial complaints for heaviness in the legs after treatment disappeared in 76.6% of patients (50 of 59 subjects); in 9 women intensity of complaints decreased. The quality of life index decreased from 42 (95% CI 28-55) to 31 (95% CI 15-52) points (p=00001). Conclusions were drawn that in intracutaneous reflux in 40.1% of cases there appear transitory evening refluxes along the GSV revealed in the day-time orthostatic test. Taking MPFFs at a dose of 1,000 mg daily during 2 months removes evening transitory reflexes in 64.4% of cases and in 35.6% of cases decrease them, thus promoting contributing to decreased intensity of. Проведено исследование по выявлению транзиторных рефлюксов по большой подкожной вене (БПВ) у пациентов с внутрикожным варикозом и изучению возможности их устранения с использованием препаратов микронизированной очищенной флавоноидной фракции (МОФФ). В исследование включено 147 женщин в возрасте от 21 до 47 лет (в среднем 31±4,4 года) с кожным варикозом (класс C1s). Длительность существования кожных проявлений составила 9,4±3,9 лет (от 4 до 24 лет). Телеангиоэктазии имелись у 69 (46,9%) пациенток, ретикулярный варикоз – у 36 (24,5%), их сочетание – у 42 (28,6%). Применен авторский тест с длительной ортостатической нагрузкой, заключающийся в проведении ультразвукового дуплексного сканирования дважды: вечером после 18 часов и утром до 10 часов утра. Оценивались вечерний и утренний диаметры БПВ, а также прирост диаметра вены при вечернем измерении в сравнение с утренним. Пациенткам с транзиторными рефлюксами по БПВ (n=59) проведено лечение препаратом МОФФ (Детралекс, Сервье) в течение 60 дней по 1000 мг ежедневно. При утреннем исследовании рефлюкс по БПВ отсутствовал. При вечернем исследовании у 59 (40,1%) человек выявлен рефлюкс по БПВ различного характера и протяженности. Все 59 пациенток с вечерними рефлюксами жаловались на повышенную утомляемость, тяжесть в нижних конечностях к концу дня. Через 2 месяца лечения из 59 женщин с исходным рефлюксом у 38 (64,4%) пациенток он отсутствовал, а у 21 (35,6%) протяженность рефлюкса уменьшилась более чем в 2 раза. Вечерний диаметр БПВ уменьшился с 5,7 мм (95% ДИ 4,0–7,1) до 5,2 мм (95% ДИ 3,5–6,5), а ортостатический градиент – с 0,9 мм (95% ДИ 0,6–1,3) до 0,6 мм (95% ДИ 0,4–0,8), р=0,000001. Исходные жалобы на тяжесть в ногах после лечения исчезли у 74,6% пациентов (50 из 59 человек), у 9 пациенток интенсивность жалоб уменьшилась. Индекс качества жизни снизился с 42 (95% ДИ 28–55) до 31 (95% ДИ 15–52) баллов (р=0,00001). Сделаны выводы, что при внутрикожном варикозе в 40,1% случаев возникают транзиторные вечерние рефлюксы по БПВ, обнаруживаемые при дневном ортостатическом тесте. Прием МОФФ по1 000 мг в сутки в течение 2 месяцев устраняет вечерние транзиторные рефлюксы в 64,4% наблюдений, а в 35,6% наблюдений уменьшает их, способствуя снижению интенсивности венозных жалоб и повышению качества жизни.

Topics: Adult; Cardiovascular Agents; Diosmin; Drug Combinations; Female; Flavonoids; Hesperidin; Humans; Lower Extremity; Quality of Life; Russia; Severity of Illness Index; Telangiectasis; Time Factors; Treatment Outcome; Ultrasonography, Doppler, Duplex; Varicose Veins

Venous hypertension combined with other pathogenetic links of the development of chronic venous insufficiency creates conditions for activation of an inflammatory process. Chronization of inflammation leads to alterations in the histological structure of the vascular wall and perivasal tissues, which is reflected by changes in their physical properties (elasticity or compressibility), which may be studied by means of ultrasound elastography (USEG).. The study was aimed at exploring the possibility of using ultrasound elastography for monitoring efficacy of conservative treatment of varicose disease of lower extremities with an agent containing a micronized purified flavonoid fraction (MPFF).. we examined a total of 19 patients (38 limbs) presenting with varicose disease of clinical class C2 according to the CEAP classification. The standard ultrasound examination and USEG were carried out using the unit of expert-class "Toshiba" (Japan) with a multi-frequency linear transducer 5-12 Hz. We examined the great saphenous vein in the area of the femur and crus, its tributaries, and the small saphenous vein. All examinations were performed with the patient in the supine, prone and standing positions from the standard approaches in the second half of the day prior to treatment with a phlebotrophic agent containing MPFF (Detralex) and three months after taking the drug at a dose of 1,000 mg/day.. at baseline, according to the findings of USEG the intact veins of the lower limbs had a homogeneous pattern of the elastogram in the perivasal area. The presence of varicose transformation was associated with an inhomogeneous elastographic picture. On the background of treatment with MPFF, all patients showed a positive clinical effect in the form of decreased intensity of manifestations of complaints or complete disappearance thereof. According to the findings of ultrasound examination, there was a tendency towards a decrease in the wall thickness and diameter of the examined veins. USEG demonstrated an increase in the perivasal zones of elastographic homogeneity of tissues. The USEG-revealed alterations were more pronounced in large-diameter vessels. On the background of treatment with Detralex there was a trend towards normalization of the elastographic pattern of the vessel as a whole.. the obtained findings confirm feasibility of using the technique of ultrasound elastography for identification of objective markers of treatment response to MPFF in varicose disease.

Topics: Biological Availability; Diosmin; Drug Combinations; Drug Monitoring; Elasticity; Elasticity Imaging Techniques; Feasibility Studies; Female; Flavonoids; Hesperidin; Humans; Lower Extremity; Male; Middle Aged; Phlebitis; Saphenous Vein; Severity of Illness Index; Treatment Outcome; Varicose Veins; Venous Insufficiency

A research program has been developed to define an evaluation tool capable of assessing the impact of venous insufficiency and its treatments on the patient's everyday life. The methodology is described in the first part of this paper, followed by the results of the first phase of the research program, based on two surveys: a "qualitative" survey in a population of severely affected patients and a "quantitative" survey in a population of 150 patients.

Topics: Activities of Daily Living; Adolescent; Adult; Aged; Aged, 80 and over; Diosmin; Drug Combinations; Female; Flavonoids; Hesperidin; Humans; Male; Middle Aged; Pain; Quality of Life; Varicose Veins; Venous Insufficiency