Family History Of Varicose Veins Research Articles

Prevalence of Varicose Veins Among Surgeons: A Cross-Sectional Study.

Background Extended periods of standing, obesity, female sex, and older age are risk factors associated with a higher probability of developing varicose veins (VV). This study aimed to determine the prevalence of VV among surgeons in public hospitals inMakkah, Saudi Arabia, and to identify the risk factors associated with this condition. Methodology This is a descriptive cross-sectional study based on a validated online questionnaire distributed via hospital WhatsApp(Meta Platforms Inc., Menlo Park, CA) groups conducted between January and June 2024. The inclusion criteria of this study were surgeons of both sexes and any age group working in the selected hospitals in Makkah City, who agreed to participate in the study. The exclusion criteria were any other healthcare workers from outside the surgical field. We included 192 participants, and Epi Info software (Centers for Disease Control and Prevention, Atlanta, GA) was used to calculate the sample size. The data were collected, reviewed, and then fed into IBM SPSS Statistics software for Windows version 21 (IBM Corp., Armonk, NY). Every participant filled out a consent form. The university ethics committee of Umm Al-Qura University, Makkah, granted ethical permission. Result This study comprised 192 surgeons in Makkah hospitals. Twenty-eight surgeons were either diagnosed with VV or had signs of VV. Varicose veins were detected among 50% of thoracic surgeons, 42.9% of pediatric surgeons, and 26.3% of orthopedic surgeons. The most reported risk factors were a family history of VV (17%), hypertension (16%), and diabetes mellitus (14%). Surgeons aged 40 years or older had a higher prevalence of VV than younger ones. Also, 55.6% of obese surgeons had VV compared to 7.8% of others with average weight. Conclusion We found that VV is a common problem, particularly among individuals with predisposing factors, such as long standing hours, smoking, pregnancy, and obesity. We found that surgeons specializing in thoracic and pediatric specialties and female surgeons were more likely to be affected by VV. Preventive measures, such as avoiding prolonged standing, wearing compression stockings, and maintaining a healthy lifestyle, are recommended.

Varicose vein disease in cabin crews and a screening scale

Aim: Varicose vein disease (VVD) and related symptoms are expected to be encountered more frequently in cabin crews. Considering their working environment, standing still for long periods of time and lacking mobility on flights may contribute to VVD. For this reason, our study aimed to determine the rate and the risk factors of VVD in cabin crew members and to develop a screening scale for VVD. Material and Methods: A questionnaire including 43 questions was applied to the participants, querying their socio-demographic, occupational characteristics, smoking history, family history, and VVD. Eight survey questions were used to establish a VVD Evaluation Scale (VVDES). Results: A total of 264 civil cabin crews participated in this study. 23.5% of civil aviation cabin crews had VVD. The diagnosis of VVD in the female group was higher than in the male group (p<0.001). A family history of varicose veins was crucial for VVD diagnosis and significantly increased the VVD risk in female cabin crew (p<0.001). It was determined that the rate of VVD was higher in cabin crews who worked on short flights (4 hours or less). It was shown that VVDES could accurately detect VVD at a rate of 77.4%. Conclusion: Family history of VVD was a crucial factor in terms of VVD. Multiple short flights have been linked to an increased risk of VVD. A VVDES has been developed in this study and can be used clinically as a screening scale for cabin crews.

RISK FACTORS OF VARICOSE VEIN IN BLUE-COLLARED WORKERS OF GLODOK MAKMUR SHOPPING CENTRE JAKARTA

Varicose veins, apart from affecting daily activities such as walking, also impact aesthetics. Varicose veins are dilated veins characterized by the bulging of blood vessels. In Europe, varicose veins are experienced by 50% of the population, while in Indonesia, it is around 25-30% of the population. Although varicose veins have a low mortality rate, the discomfort, swelling, and hyperpigmentation they cause can progress to more complex health problems. This study aims to determine the risk factors for lower limbs varicose veins in blue-collar workers at the Glodok Makmur shopping centre Jakarta. A case-control design was used in this research. A total of 40 cases, namely male workers with lower limb varicose veins, and 40 controls, namely male workers without lower leg varicose veins, were selected using purposive sampling. Data from respondents were collected through questionnaires and analyzed using the Chi Square test with a significance of ? = 0.05. From the results of the analysis, it was found that lower limbs varicose veins had a significant relationship with high BMI (OR = 4.667, 95% CI = 1.507-14.455), dominant working position standing (OR = 7.071, 95% CI = 2.519-19.850), smoking habits (OR = 0.648, 95% CI = 0.503-3.018), and family history of varicose veins (OR = 6.000, 95% CI = 2.207-16.313). The results of this study indicate that high BMI, dominant working position standing, smoking habit, and family history of varicose veins are potential risk factors for the occurrence of lower leg varicose veins in blue-collar workers at the Glodok Makmur shopping centre Jakarta.

Differences in risk profile associated with varicose veins and chronic venous insufficiency - results from the Bonn Vein Study 1.

Background: The aim of this publication is to demonstrate similarities and differences in the association of risk factors with the prevalence of different manifestations of chronic venous disease (CVD), like varicose veins (VV), venous oedema (C3) and severe chronic venous insufficiency (CVI) in the population-based cross-sectional Bonn Vein Study 1 (BVS). Patients and methods: In the BVS 1 between 13.11.2000 and 15.3.2002, 3.072 participants, 1350 men and 1722 women, from a simple random sample of the general population of the city of Bonn and two rural townships aged 18-79 years were included. The overall response proportion was 59%. All participants answered a standardized questionnaire including information about socio-economic data, lifestyle, physical activity, medical history, and quality of life. Venous investigations were performed clinically and by a standardized duplex examination by trained investigators. The CEAP classification in the version of 1996 was used to classify the findings. Logistic regression models were performed for the association of possible risk factors with VV, venous edema (C3) and severe CVI (C4-C6). The predictive risk (PR) describes the association of the diseases and the possible influencing factors. Results: VV, venous oedema (C3) and severe CVI (C4-C6) have common risk factors like higher age, number of pregnancies, family history of VV and overweight or obesity. Female gender is significantly associated with VV and C3 but not with severe CVI (C4-C6). High blood pressure and urban living are only associated with C3 and C4-C6 disease whereas prolonged sitting is associated with C3 and lower social class with C4-C6 exclusively. Discussion: In many epidemiological studies risk factors were associated with chronic venous disorders in general. Our data show that VV, venous edema and severe CVI may have different risk profiles. Venous edema is more often associated with arterial hypertension and sedentary lifestyle whereas lower social class seems to be a risk factor for severe CVI including venous ulcers. Conclusions: The differences in the association of risk factors to VV, venous edema and severe CVI should be considered if prevention and treatment of chronic venous diseases are planned. As examples, compression stockings could be proposed in sitting profession to prevent oedema, VV patients with risk factors like obesity might benefit from early treatment for VV and obesity. More longitudinal evaluation of risk factors is necessary to evaluate the true risk profile of CVD.

Evaluating the Prevalence and Risk Factors of Varicose Veins in Surgeons and Operating Room Staff at Buraidah Center Hospital.

Background Varicose veins (VVs), which are characterized by visible, convoluted veins in the lower limbs, are a prevalent disorder that afflicts a substantial portion of the population. The purpose of this cross-sectional study was to look at the prevalence and risk factors for VVs among surgeons and operating room personnel at Buraidah Central Hospital in Saudi Arabia. They usually become worse over time once they develop, which highlights the importance of early intervention and preventive actions. Methodology Data from 91 participants were collected from diverse healthcare professionals between August 2023 and September 2023 via an online questionnaire covering demographics, health, and occupational factors. The chi-square and Fisher's exact tests were employed to examine the correlation between these variables and the occurrence of VVs. Results The data analysis revealed that several specific factors displayed notable associations. Occupations as Surgical Physicians, OR Staff, or Nurse (p=0.009), the number of days worked in the operating room (p=0.040), the role in the operating room, especially those mainly standing (p=0.001), contraceptive pill usage (p=0.000), and vaginal delivery (p=0.037) displayed statistically significant relationships with VVs. In contrast, factors like gender, age group, ethnicity, family history of VVs, social status, smoking habits, exercise frequency, BMI, lifting heavy objects, and years in the field did not reveal substantial associations with VVs, as indicated by p-values exceeding 0.05. Conclusion The study identified a low VV diagnosis prevalence, with an equal distribution among male and female respondents. Key factors that contribute to the risk of developing VVs include the number of days worked in the operating room, the role in the operating room, a family history of VVs, contraceptive pill usage, and the method of delivery.

Prevalence of Varicose Veins and Its Risk Factors among Nurses Working at King Khalid University Hospital Riyadh, Saudi Arabia: A Cross-Sectional Study.

This quantitative observational cross-sectional study assessed the prevalence and level of risk scores for varicose veins among nurses, and the association between varicose veins and sociodemographic, occupational, and lifestyle risk factors. Using simple random sampling, from August-December 2022, 250 nurses from different departments at King Khalid University Hospital completed a validated self-administered questionnaire and underwent an observational physical examination. Most nurses (191) had low-risk scores for varicose veins, 46 nurses had moderate-risk scores, and 13 nurses had high-risk scores. From the outpatient clinics, 61.5% of nurses had significant high-risk scores for varicose veins. Those with a statistically significant association had a family history of varicose veins (p < 0.001) and other chronic medical conditions (p = 0.04). Physical activity, especially race-walking/running (p = 0.006), showed a statistically significant association with the varicose veins score. The years as a staff nurse were statistically significant among the occupational risk factors (p = 0.003). The adjusted multivariable regression model showed three significant predictors: a positive family history, running/walking, and total years as a staff nurse (p < 0.001, p = 0.02, and p < 0.001, respectively). Nurses working at outpatient clinics, positive family history, years as a staff nurse, and other chronic conditions are risk factors for varicose veins, while race-walking/running is a protective factor.

A Study of Demographic Factors and Clinical Profile of Varicose Veins in Adults

BACKGROUND&#x0D; Varicose veins in lower limbs cause a lot of morbidity in humans and a significant financial burden on the health care system. Varicose veins do not threaten life and are seldom disabling. A high prevalence of varicose veins has been documented in India. Hence, we decided to conduct a study on the demographic factors and clinical profile of varicose veins in adults.&#x0D; METHODS&#x0D; It is an observational study. 200 patients aged&gt;12 years with varicose veins of the lower limbs were studied. Statistical Analysis was performed with help of Epi Info (TM) 7.2.2.2.&#x0D; RESULTS&#x0D; 200 patients were studied, of whom 87.5 % were aged ≥ 35 Years; 74.5 % were males, 25.5 % were females; 70.0 % had normal BMI, 75.9 % were from the urban area, 11.5 % had a family history of varicose veins, 10.5 % had addictions, 57.0 % had a duration of standing &gt;5 hours. 62.0 % were examined at OPD, 82.5 % were unilateral and 17.5 % bilateral. The heights of the patients were significantly higher than the normal height of average Indians. The most common symptoms were varicosities and pain present in 80.85 % and 71.49 % of cases respectively. Out of 235 lower limbs, 48.93 % had the involvement of only GSV, 18.72 % only SSV, 32.35 % both; incompetent saphenofemoral junction was present in 67.24 % clinically and 74.89 % radiologically; 150 mid-thigh, 62 above-knee, 55 below-knee, 106 calf, 72 ankle perforators were incompetent clinically; 165 mid-thigh, 80 above-knee, 65 below-knee, 118 calf, 95 ankle perforators were incompetent radiologically; 65 (27.66 %) belonged to C2 class, 60 (25.53 %) to C4 class and 60 (25.53 %) to C6 class.&#x0D; CONCLUSIONS&#x0D; Age &gt; 35 years, male gender, tall height, and prolonged standing are associated with increased risk of varicose veins whereas obesity, family history and addictions do not have any association. Varicose veins are more commonly unilateral with the involvement of a great saphenous vein. Colour Doppler is better at detecting incompetent perforators compared to clinical assessment.

Risk Assessment of Varicose Veins Among Teachers in Al-Ahsa, Saudi Arabia.

BackgroundVaricose veins (VV) are abnormally swollen, tortuous, and prominent veins caused by insufficient venous valves leading to venous congestion and elevated venous pressure. Prolonged standing at work has been proposed to be an important risk factor for varicose veins. Teachers are prone to have varicose veins due to prolonged standing. The aim of this study was to assess the risk of varicose veins among teachers in Al-Asha, Saudi Arabia.MethodThis was a cross-sectional study conducted among teachers of primary, secondary, and high schools in Al-Ahsa, of both genders, between April 2022 and June 2022. The participants were interviewed and examined for the presence of signs and symptoms of the disease. Finally, the collected data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 26.0 for Windows) software.ResultOut of 399 participating teachers with a mean age of 43.2 ± 12.9 years, 216 (54.1%) were males and the remainder were female. The commonest symptom was pain in the legs, which was exacerbated by work (43.1%). Most of the participants were working for more than 16 years (43.6%) and standing for less than six hours per day (72.7%). The most pointed sign was spider legs-shaped veins (23.8%). However, the least collective sign was paleness in the ulcer area after healing (1.8%). A total of 140 teachers had a family history of varicose veins, 74 of them (18.5%) were diagnosed with varicose veins previously. We summarize our result as female teachers who have a family history of VV have more risk to develop the disease.ConclusionThe prevalence of varicose veins was high among teachers in Al-Ahsa, Saudi Arabia. According to our study, teachers have a significant chance of developing the condition since their working style contributes to its progression. Further actions need to be made in order to increase awareness and prevent its complications.

Factors associated with chronic venous disease: study in 1,136 patients treated for varicose veins of the lower limbs in a specialized clinic.

Varicose veins are a highly prevalent condition in the general population, generating variable reasons for consultation that can alter the patient's quality of life, with prevalence and associated factors that vary in different series. To describe the epidemiological profile of patients who consulted for varicose veins by evaluating main symptoms and associated variables. Between 2019 and 2020, 1,136 patients attending vascular surgery consultation in a specialized outpatient center were evaluated. Demographic variables, presented symptoms, complications, and associated factors, such as body mass index, parity and family history, were recorded. A total of 1136 patients were evaluated (79.8% women and 20.2% men), with a mean age of 53.51 years. The presence of symptoms was similar in men and women; the most frequent complications were ulcer, varicorrhage, and superficial venous thrombosis. Most patients showed CEAP 1, 2 and 3 (n = 909) and more than half were overweight or obese (n = 679) with a predominance of those classified as C4. Sixty-nine per cent had a positive family history of varicose veins. There was no difference between severity of varicose veins and time working in the standing or sitting position, but there was a greater presence of C5 or C6 ulcer among patients standing for more than 4 hours. Describing the characteristics of patients with varicose veins helps to understand the disease and to focus efforts towards those who are more susceptible. The results of this research are similar to those found in other populations.

Epidemiologia das doenças venosas crônicas: um estudo de 1136 pacientes tratados por varizes de membros inferiores em uma clínica especializada na Colômbia

BackgroundVaricose veins are a highly prevalent condition in the general population, generating variable reasons for consultation that can alter the patient’s quality of life, with prevalence and associated factors that vary in different series.ObjectivesTo describe the epidemiological profile of patients who consulted for varicose veins by evaluating main symptoms and associated variables.MethodsBetween 2019 and 2020, 1,136 patients attending vascular surgery consultation in a specialized outpatient center were evaluated. Demographic variables, presented symptoms, complications, and associated factors, such as body mass index, parity and family history, were recorded.ResultsA total of 1136 patients were evaluated (79.8% women and 20.2% men), with a mean age of 53.51 years. The presence of symptoms was similar in men and women; the most frequent complications were ulcer, varicorrhage, and superficial venous thrombosis. Most patients showed CEAP 1, 2 and 3 (n = 909) and more than half were overweight or obese (n = 679) with a predominance of those classified as C4. Sixty-nine per cent had a positive family history of varicose veins. There was no difference between severity of varicose veins and time working in the standing or sitting position, but there was a greater presence of C5 or C6 ulcer among patients standing for more than 4 hours.ConclusionsDescribing the characteristics of patients with varicose veins helps to understand the disease and to focus efforts towards those who are more susceptible. The results of this research are similar to those found in other populations.

Prevalence of Varicose Veins Among Nurses at Different Departments in a Single Tertiary Care Center in Riyadh.

BackgroundVaricose veins (VV) is a chronic venous disease that affects the lower extremities. It is the dilation of subcutaneous veins, three to four millimeters in diameter. VV can be attributed to several risk factors such as age, obesity, multiple parities, heavy lifting, and long-standing hours. Direct and indirect complications can occur due to VV. Several studies were conducted to estimate the prevalence of VV.MethodsA self-administered questionnaire was used to estimate the prevalence of VV among nurses from different departments in the National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia. The questionnaire included questions on weight, height, work history, lifestyle, and multiple diseases. The chi-square test and Fisher’s exact test were used for testing the association between the various predictors and the diagnosis of VV.ResultsA total of 366 nurses participated in the study. There were 40 (39 females and one male) cases of VV accounting for 11.0%. Variables that have a statistically significant association with VV were social status and lifting heavy objects (p=0.02), a family history of VV (p-value=<0.001), and the number of childbirths (p=0.04). The observation of each department was not statistically significant with VV (p=0.35).ConclusionAmong nurses, positive family history, age, marital status, long-standing hours, and heavy object lifting were significant risk factors for the development of VV. However, the prevalence of VV in the four departments was low.

Varicose Veins: Prevalence and Associated Risk Factors among Women of Childbearing Age Attending a Primary Health Care Unit in Cairo, Egypt

Background: Varicose veins are very common and affect individuals of all ages; however, unfortunately, their aetiology is partially understood. There is a scarcity of studies in Egypt investigating their prevalence and associated risk factors, especially among women of childbearing age. Objectives: This study was conducted to measure the prevalence and identify the risk factors associated with varicose veins among women of childbearing age (15-55 years old) attending primary healthcare center in Cairo. Methods: A cross-sectional study was conducted on 231 women attending El-Nahda center in the El-Salam medical area in Cairo, selected by systematic random sampling technique. Data were collected using an interview questionnaire and clinical examination. Results: the study shows that among 231 women of childbearing age (15-55 years old) attending primary healthcare center in Cairo, (51.1%) had varicose veins, and the most significant associated risk factors were age (35.84±9.14 years), weight (78.13±13.62 kg), duration of standing during a working day (7.72±2.54 days), hypertension (72%), lack of physical activity (56.9%), and family history of varicosities (45.5%). Conclusion: There was a high prevalence of leg varicose veins among the participants, and the risk of varicose veins increases with increasing age, prolonged standing, hypertension, having family history of varicosities and the absence of regular physical exercise. Recommendations: Health education programs should aim at controlling preventable risk factors for varicose veins, and screening for women with a family history of varicose veins should be strengthened.

A prospective study on etiology and clinical features of varicose veins: A hospital based study

Background: Varicose vein are abnormally dilated, tortuous, elongated veins of lower limbs which have permanently lost their valvular efficiency. The main objectives of our study was to study etiological profile (Age, sex, occupation and site pathology) and different modalities utilized in our institute and to assess and study final outcome in patients included in our study. Methodology: It was a prospective study; fifty cases of varicose veins were attending outpatient Department and admitted in the Surgical Department of Deccan Medical College & Hospital from October 2018 to September 2019. Results: In the present study, fifty cases of varicose veins treated in our institute form the basis of this study. The average age of the patients was 41.86 years. The youngest patient was of 19 years and the oldest was 65 years of age. Varicose veins were common in males; the male to female ratio was 3.1:1. The number of patients who were involved in occupations requiring prolonged hours of standing was 35 (70%). A positive family history of varicose veins was present in only 4 cases (8%). Deep vein thrombosis was present in 7 patients (12.72%). The commonest presentation was dilated veins. The common associated symptoms were itching and pigmentation in 27 patients (54%) and ulceration in 13 patients (26%). 5 patients had bilateral varicose veins and the remaining 45 had only one limb affected. The limb commonly affected was right lower extremity in 29 cases (52.7%). Long saphenous vein was involved in 42 limbs (76.36%) and both long and short saphenous vein were affected only in 3 limbs (5.4%). Conclusion: The database of our retrospective study regarding age & sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.

Current situation of lower limb varicose veins and its influencing factors among clinical nurses

Objective To investigate the current situation of lower limb varicose veins among clinical nurses at a ClassⅢ Grade A hospital and analyze its influencing factors, so as to provide a basis for further intervention and improving protective level. Methods From July 2018 to August 2018, we selected 810 clinical nurses at a ClassⅢ Grade A hospital as subjects by convenience sampling. We collected patients' general information and carried out questionnaire survey with the self-designed lower limb varicose veins questionnaire for nurses. Receiver operating characteristic (ROC) curve was used to multivariate prediction of the optimal area under curve (AUC) and critical value. Single factor analysis adopted χ2 test, and the influencing factors analysis adopted the multiple Logistic regression. Results In this study, a total of 827 questionnaire were sent out and 810 of them were valid with 97.94% for the valid recovery rate. There were 289 (35.68%) clinical nurses with lower limb varicose veins. ROC curve analysis showed that the high-risk cutoff values of ages, nursing years and walk time during work of lower limb varicose veins were 29 years old (AUC=0.611, P<0.001, 95%CI: 0.572-0.650) , 8 years (AUC=0.623, P<0.001, 95%CI: 0.584-0.661) and four hours (AUC=0.604, P<0.005, 95%CI: 0.565-0.643) respectively in nurses. Single factor analysis showed that there were statistical differences in the sexes, ages, education levels, positional titles, nursing years, whether having the family history of varicose veins, whether having the history of deep vein thrombosis, night shift conditions, childbearing history, whether taking oral contraceptives, wearing elastic stockings and walk time during working (P<0.05) . Multiple Logistic regression analysis found that the main influencing factors of lower limb varicose veins of clinical nurses included ages, nursing years, having family history of varicose veins, wearing elastic stockings and walk time during working (P<0.05) . Conclusions The incidence of lower limb varicose veins is high in nurses because of profession with the phenomenon of universally inadequate protective measures. Reasonable and comprehensive protection measures should be taken positively to improve the current situation. Hospital managers should attach importance to the situation, and develop related knowledge training or provide elastic stockings for nurses by taking a perspective of caring staff to reduce the occupational injuries of nurses and extend their careers. Key words: Nurses; Lower limb varicose veins; Influencing factors; Protective measures; ROC curve

Major risk factors for chronic venous disease development in women: is childbirth among them?

ABSTRACTMany studies have reported that Chronic venous disease (CVD) occurs more in females than males, due to pregnancy. The study was conducted over the period 2014–2015 at the Dermatovenereological clinic, Novi Sad, Serbia. We performed a cross-sectional study of 554 women. According to Clinical-Etiology-Anatomy-Pathophysiology (CEAP) staging, the sample was divided into three groups: Mild CVD (classes 1–3 by CEAP) – n = 72; Severe CVD (classes 4–6 by CEAP) – n = 122 and a Control (no CVD) – n = 360 patients. The age range of participants was 18 to 93 years (average 54.92 years). Most important CVD risk factors were examined in detail. Out of 554 examinees, 22.03% had severe CVD, and 12.99% had mild CVD. Bivariate analyses showed a significantly higher proportion of women who had deliveries in the severe CVD and mild CVD groups, compared with the control group. Other significantly related factors were older age, family history of varicose veins, standing job position and hypertension. After performing multiple logistic regression analysis, older age, standing job position and family history of varicose veins remained significant, while childbirth lost its significance. Our results suggest that childbirths are not associated with the occurrence of CVD

A study to analyses the clinical features and various treatment modalities of varicose veins of lower limbs

Background: Varicose veins are defined by WHO as abnormally dilated saccular or cylindrical superficial veins, which can be circumscribed or segmental. This includes tiny spider telangiectasia’s as well as grossly dilated saphenous varicosities. It involves at least 1 out of 5 in the world and with increasing population, increased life span and change in life style, the problem is ever growing. The objective of this study is to analyse the clinical features and various treatment modalities adopted for the management of varicose veins of 40 has some form of varicosity or telangiectasia of the veins.Methods: A prospective study was conducted in CG hospital and Bapuji hospital attached to JJM Medical College, Davangere from June 2009 to May 2011. A total of 40 cases were included in the study duration. All patients who presented to the outpatient department with signs and symptoms of primary varicose veins were interviewed with preformed performa, meticulously examined and later subjected to color doppler studies before they underwent surgery for the same.Results: The incidence of varicose veins was seen most commonly in male when compared to female in this study. The family history of varicose veins was seen in only 12.5% of the subjects. In this study patients presented with varied symptoms, out of which dilated veins was most common 37 (92.5%) patients followed by aching pain 22 patients (55%).Conclusions: Varicosity of the lower limb is a common clinical entity. The number of cases reporting to the hospital is much less than the real incidence because in the absence of symptoms due to varicose veins patients do not seek treatment in our country. Most of the patient presented to the hospital for one or the other complications not for the cosmetic purpose.

The Case of GSV Transient (Evening, Orthodependent) Reflux in a Hip Going into the Tributary in Woman with Reticular Varicose Veins (C1s)

A 41-year-old woman presents with complaints of aesthetic defect of legs. She works as a shop assistant in a store. Her working day in a standing position lasts up to 10 hours. She has been pregnant twice and now has two children. She notes the family history of varicose veins from mother’s side. While evening examination at 6 p.m. (after her working day) the skin is of normal colour and there is an artery pulsation in all pulse points. Both hip superficies contain spider veins and single reticular varicose. She states leg heaviness and tiredness, aching in the internal hip surface of the right leg in its lower part at the end of the working day, night cramps. The results of DS after «a day orthostatic loading test» (shortly DOL-test) showed that the diameter of GSV in the right area of saphenofemoral junction is 6.5 mm which is the same for the area between the middle and the lower third of the hip. There is a 12 cm reflux in the middle third of the hip going into the extended hypodermic tributary with commissural GSV valve insufficiency in the area between the middle and the lower third (Figure 1).

Progression of varicose veins and chronic venous insufficiency in the general population in the Edinburgh Vein Study.

The natural history in the general population of chronic venous disease in the legs is not well understood. This has limited our ability to predict which patients will deteriorate and to assign clinical priorities. The aims of this study were to describe the progression of trunk varicose veins and chronic venous insufficiency (CVI) in the general population, to identify important lifestyle and clinical prognostic factors, and to determine the relationship between venous reflux and progression. The Edinburgh Vein Study is a population-based cohort study in which randomly selected adults aged 18 to 64 years had an examination at baseline. This included a questionnaire on lifestyle and clinical factors, standardized assessment and classification of venous disease in the legs, and duplex scan to detect venous reflux in eight segments of each leg. A follow-up examination 13 years later included a reclassification of venous disease to ascertain progression in the development or increase in severity of varicose veins and CVI. Among 1566 adults seen at baseline, 880 had a follow-up examination, of whom 334 had trunk varicose veins or CVI at baseline and composed the study sample. The mean (standard deviation) duration of follow-up was 13.4 (0.4) years. Progression was found in 193 (57.8%), equivalent to 4.3% (95% confidence interval [CI], 3.7-4.9) annually. In 270 subjects with only varicose veins at baseline, 86 (31.9%) developed CVI, with the rate increasing consistently with age (P = .04). Almost all subjects (98%) with both varicose veins and CVI at baseline deteriorated. Progression of chronic venous disease did not differ by gender or leg, but a family history of varicose veins and history of deep venous thrombosis increased risk (odds ratio [OR], 1.85 [95% CI, 1.14-1.30] and 4.10 [95% CI, 1.07-15.71], respectively). Overweight was associated with increased risk of CVI in those with varicose veins (OR, 1.85; 95% CI, 1.10-3.12). Reflux in the superficial system increased the likelihood of progression, especially in combination with deep reflux (OR, 2.57; 95% CI, 1.55-4.25) and when located in the small saphenous vein (OR, 4.73; 95% CI, 1.37-16.39). Nearly half of the general population with chronic venous disease deteriorated during 13 years, and almost one third with varicose veins developed skin changes of CVI, increasing their risk of ulceration. Age, family history of varicose veins, history of deep venous thrombosis, overweight, and superficial reflux, especially in the small saphenous vein and with deep reflux, might influence the risk of progression.

Changes in the diameter and valve closure time of leg veins in primigravida women during pregnancy.

The aim of this study was to monitor the changes that develop in leg veins of primigravida women during pregnancy. Sixty primigravida women volunteered to undergo clinical evaluation and duplex ultrasound examination of both lower limb veins to monitor changes in vein diameter and valve closure time (VCT) during pregnancy and 3 months postpartum by duplex ultrasound. A total of four readings were taken for each subject, one reading for each trimester and the last reading at 3 months postpartum. The mean (± standard deviation) age of participants was 26.82 ± 2.47 years; 39 limbs (32.5%) and 65 limbs (54.2%) developed C1-C3 venous changes during the second and third trimesters, respectively. Three months post partum, 36 limbs (30%) continued to have C1-C2 changes. Only four limbs in four subjects developed varicose veins along the great saphenous vein, and their VCT was more than 1 second. These subjects were found to have a family history of varicose veins. Duplex examinations showed that there was a gradual increase in the diameter and VCT from the second trimester through the third trimester of pregnancy in all examined venous segments. These changes were statistically significant by Friedman and related-samples Wilcoxon signed rank tests within the same legs (P = .001) but not between legs in the same subject (P > .05), even with adjustment for body mass index (P = .001-.049). In primigravida women, lower limb veins showed gradual increase in vein diameter and in VCT starting from the second trimester. These changes reverted to baseline in most cases 3 months after delivery.

Estudio descriptivo del manejo de la insuficiencia venosa crónica entre niveles asistenciales

IntroductionThe coordination between levels of care is an essential element to increase the efficiency of the health system. Vascular diseases, in particular would benefit from this due to its frequency, severity and vulnerability. Owing to the high prevalence of the disease, there is currently a disproportionate number of patients being referred from Primary Care (AP) to Specialist Units (AE), with a suspected diagnosis of chronic venous insufficiency of the lower limbs (IVC MMII) without really having this diagnosis confirmed. This leads to collapse in AE consultations, diagnostic delay, lost workdays, as well as all the public health, social and economic repercussions. ObjectiveThe aim of this study is to assess the reality of this disease in the Huelva Costa Health District. Patients and methodsA descriptive study was conducted on a population of Huelva Coast Area Health seen by a Primary Care doctor to consult on lower limb venous pathology. The study also included a questionnaire to determine the level of knowledge about this disease of the Primary Care physician, as well as the need for conducting continuing education courses and analyse whether these courses provide professionals with the necessary skills for a good daily practice against this clinical condition. ResultsThe first data obtained show that only 42.4% of cases referred from Primary Care had a correct diagnosis. There is a statistically significant association between diagnostic accuracy and risk factors/symptoms, such as nearby heat source, a family history of varicose veins, heavy legs, thick veins in the lower limbs, swelling of the legs at the end of the day, and being female. ConclusionThere appears to be an inappropriately high number of patients referred from Primary Care to Specialists due to suspicion of IVC, in which the diagnosis is not confirmed.