Injection Treatment Of Varicose Veins Research Articles

Estimating Incubation Period and Predicting Risk of Developing Hepatocellular Carcinoma in Patients with HCV Infection from the Clinic of a County-Level City in China

Background: To estimate incubation period in patients infected with hepatitis C virus (HCV) and to predict patients’ risk of developing hepatocellular carcinoma (HCC) for indicating health policymaking. Methods: An outbreak of HCV infection from a clinic was occurred due to the injection treatment of varicose veins called minimally invasive thrombolysis and meridian activating therapy (MITMT) in a county-level city of China. Conventional method and bootstrapping approach were used to estimate HCV incubation period. Risk assessment model generated from the previous study was applied to predict the risk of developing HCC in the coming 5-, 10-, and 15-year for HCV infected patients from the above outbreak. Results: A total of 120 subjects were underwent MITMT between October 22, 2012 and January 28, 2013; of those, 99 subjects were diagnosed with HCV infection. Mean age of the subjects was 54.42 years old, and females were accounted for 51.5% in contracted subjects. Mean incubation period of hepatitis C (HC) was 45.76 days using first MITMT as infected date and 30.68 days using bootstrapping approach, their standard deviations were 23.01 and 15.05 days, respectively. A total of 1.3, 4.7, and 10.6 persons will be developed into HCC in the coming 5, 10, and 15 years in infected subjects based on a risk prediction model. Conclusion: Some patients with HCV infection from a nosocomial clinic in a county-level city will be suffered from more severe HCC in the coming decade; effective measures and controls were urgently needed to manage these patients with high risk of developing into end-stage liver disease.

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., F.R.C.P. (Lond.), Assistant Physician to Guy's Hospital. Fifth edition. Crown 8vo. Pp. 58 + x. 1929. London: H. K. Lewis & Co. Ltd. 4s. net

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., F.R.C.P. (Lond.), Assistant Physician to Guy's Hospital. Fifth edition. Crown 8vo. Pp. 58 + x. 1929. London: H. K. Lewis & Co. Ltd. 4s. net

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., M.R.C.P. (Lond.), Assistant Physician to Guy's Hospital. Third edition. Crown 8vo. Pp. 51 + x. 1928. London: H. K. Lewis & Co. Ltd. 4s. net

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., M.R.C.P. (Lond.), Assistant Physician to Guy's Hospital. Third edition. Crown 8vo. Pp. 51 + x. 1928. London: H. K. Lewis & Co. Ltd. 4s. net

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., M.R.C.P., Assistant Physician, Guy's Hospital. Fourth edition. Crown 8vo. Pp. 58 + x. 1929. London: H. K. Lewis & Co. Ltd. 4s. net

The injection treatment of varicose veins. By A. H. Douthwaite, M.D., M.R.C.P., Assistant Physician, Guy's Hospital. Fourth edition. Crown 8vo. Pp. 58 + x. 1929. London: H. K. Lewis & Co. Ltd. 4s. net

Injection treatment of varicose veins: Radiological and histological investigations of methods

Injection treatment of varicose veins: Radiological and histological investigations of methods

Hæmodgnamics. The mechanism of venous, capillary, and lymphatic flow; œdema; and Injection Treatment of Varicose Veins. By P. R. Kittel, F.R.C.S., Assistant Surgical Officer at the Royal Northern Hospital, London. Crown 8vo. Pp. 196 + xi, with 3 plates and other illustrations. 1929. London : H. K. Lewis & Co. Ltd. 10s. net

Hæmodgnamics. The mechanism of venous, capillary, and lymphatic flow; œdema; and Injection Treatment of Varicose Veins. By P. R. Kittel, F.R.C.S., Assistant Surgical Officer at the Royal Northern Hospital, London. Crown 8vo. Pp. 196 + xi, with 3 plates and other illustrations. 1929. London : H. K. Lewis & Co. Ltd. 10s. net

Treatment of varicose veins: An update

The modern injection-compression sclerotherapy, as described by Fegan of Ireland and Sigg of Switzerland, bears little resemblance to the injection treatment of varicose veins as used in the United States in the 1940s. Sotredecol (sodium tetradecyl sulfate) is the agent injected, and no more than 0.5 ml is used at any one site. The sites picked are those of the incompetent perforator veins which are found by careful physical examination. The injection is made into the emptied vein with the leg raised, and a firm compression dressing is applied as the injections are made from below cephalad. The compression bandage is worn for 3 weeks. Randomized studies that compared surgery and injection-compression sclerotherapy in the treatment of varicose veins have shown little difference in the end results. The overall cost, including hospitalization, work days lost, and complications, are greater with surgery. A series of 66 patients has been analyzed.

The Injection Treatment of Varicose Veins: a Follow-Up Study of 264 Patients

The Injection Treatment of Varicose Veins: a Follow-Up Study of 264 Patients

A modern approach to the injection treatment of varicose veins and its applications in pregnant patients

We should make it clear that we are in no way opposed to the surgical treatment of varicose veins when this implies accurate location of the perforators with their interruption and ligation followed by repair of the fascial orifice transmitting the perforators. We are completely opposed to the old injection therapy which resulted in uncontrolled thrombosis. The inherent advantages of our technique are as follows: (1) immediate relief of symptoms, (2) absence of mortality and morbidity, (3) simplicity of application, (4) an outpatient treatment, (5) inexpensive, (6) avoidance of phlebitis and pulmonary embolism in the puerperium.

A Reappraisal of the Injection Treatment of Varicose Veins

A Reappraisal of the Injection Treatment of Varicose Veins

The postphlebitic state

I N 1918 Homans’ reported his important observation regarding the disproportion between the degree of superIicia1 venous engorgement and the intractabiIity to treatment of certain uIcers of the Iower extremity foIIowing deep venous thrombosis. Since then a cIinica1 entity has emerged which has come to be known as the postphIebitic syndrome. In 1928 Homans presented a description of this condition which up to the present has not been surpassed: “One can hardIy see many patients suffering from uIcers of the Ieg without being struck by the number of those who present areas of edema, induration, discoIoration and uIceration for which varicose veins of the famiIiar types are cIearIy not responsibIe. Such areas are often extensive, unassociated with trauma and seem to have no adequate cause. They are the source of much pain and disabiIity, particuIarIy in the working cIass. “In questioning a considerabIe group of such patients it wiI1 be found that many have suffered at some time from a recognized thrombophIebitis, that is, a ‘miIk Ieg,’ or a simiIar disease occurring in the course of convaIescence from an operation or an acute fever such as typhoid or pneumonia. In some instances the connection between the Iate compIications and the thrombophIebitis is very direct and obvious, in others remote and obscure. As a ruIe venous stasis, as exhibited by diIated veins or bIueness of the extremity, is IittIe marked or aItogether absent. On the other hand, the condition which one is accustomed to associate with acute or chronic Iymph stasis, that is edema of the tissues, is aImost invariabIy present. The cause of these Iate resuIts is perhaps to be found in the nature of the origina thrombosis.” The diagnosis often wiI1 be obscure unIess one is aIert to such a possibiIity. Examination may fai1 to reveal superficia1 varicosities and a cursory history may not eIicit a story of an antecedent episode of thrombophIebitis. FaiIure to appreciate the specific nature of the condition often Ieads to its confusion with varicose veins and varicose ulcer. In order to establish a proper diagnosis it is frequentIy necessary to deIve into the remote recesses of memory to ferret out an episode of miIk Ieg or a fracture which may have occurred as much as twenty to fifty years before. Further questioning, however, wiI1 usuaIIy revea1 that there has been some residue of ankIe sweIIing during the intervening years. More diffrcuIt to evaIuate are those cases with cIear-cut varicosities but a history of treatment by muItipIe injections. The injection treatment of varicose veins was often very probabIy compIicated by deep venous thrombosis. At Ieast three processes seem to be invoIved in the pathogenesis of the postphIebitic state, nameIy, damage to the deep veins, invoIvement of the Iymphatic drainage and reffex vasospasm. The invoIvement of the deep veins can be demonstrated in various ways, such as by phIebography and by waIking venous pressures. Furthermore, destruction of venous vaIves as a resuIt of thrombophIebitis has been described in both cIinica1 and experimenta materia1 by Edwards and Edwards.3 AIthough Homans in his earlier work beIieved rather strongIy that an inffammatory process in the periphera1 Iymphatics was an important factor, its uItimate significance has been dif&uIt to evaIuate. He was one of the first4 to describe the marked edema present in the vascuIar bundIe at operation during acute thrombophIebitis. It is a common finding during expIoration for the purpose of femora1 vein interruption in the acute phase of the disease. Ochsner and DeBakey6 have pointed out the importance of reflex vasospasm during the acute episode. ParavertebraI procaine bIocks may have a markedIy moIIifying effect on the acute symptomatology. It is doubtfu1, how-

Platform device for examination and injection treatment of varicose veins.

It is becoming increasingly apparent that the most effective method of treatment for varicose veins is a complete stripping procedure. This operation can be performed with the patient under local anesthesia, and he can be semiambulatory. There are, however, certain indications for the injection treatment of varicosities. Injections of sclerosing solution are useful for the treatment of large nevi araneosi (spiders), and they are also of value after operation if there are any residual varicose vein segments. While a great variety of techniques for the injection treatment of varicose veins has been described, most authors prefer the empty vein technique for the following reasons: 1. The irritant exerts its maximum effect when the vein is empty. 2. There is minimum postinjection reaction. 3. Large postinjection thrombi (which may take months to absorb) do not develop. The empty vein technique may be carried out effectively in the following manner. The patient

Allergic Manifestations after the Injection Treatment of Varicose Veins

THE treatment of varicose veins by the injection method started in Europe, being used in 1904 by Tavel and in 1912 by Linser. During and after World War I numerous sclerosing agents were employed by Sicard and Gaugier, Montpellier, Genevrier and Dowthwaite, Noul and Troisier. Melkon1 reviewed the history of the treatment of varicose veins in a paper published in 1929. Since then, various sclerosing agents have been used by many surgeons who gave injections freely and without too much consideration of possible dangers. It is time to call attention to the possible dangers in the use of sclerosing material. . . .

FATAL PULMONARY EMBOLISM FOLLOWING VARICOSE VEIN INJECTION

To the Editor:— Drs. Vaughn and Lees have contributed much to medical science by publishing and evaluating a case of Fatal Pulmonary Embolism Following Varicose Vein (The Journal, April 11, p. 1293). They deserve the highest appreciation for their honesty and courage. The mechanism of occlusion of the vein after the injection of different obliterating solutions has been studied microscopically by many authors (McPheeters, H. O.: Injection Treatment of Varicose Veins, Philadelphia, F. A. Davis Company, 1938, chapter 29, pp. 133-145). It requires several days' time from the onset of the injury of the endothelial lining of the varicose vein to the point at which the whole lumen of the vein is tightly filled with a well attached thrombus. As a rule, after the injection of the sclerosing solution not the entire endothelial lining of the vein is injured uniformly. Islands of destroyed endothelium have been found with stratified

SURGERY VS. INJECTION TREATMENT OF VARICOSE VEINS

To the Editor:— A communication to the editor ofThe Journal, May 25, 1940, page 2139, by Isaak Ludwig discussing the paper of Dean and Dulin suggests the many inconsistencies in the present discussion and treatment of varicose veins. In their paper, Dean and Dulin state that there are more fatalities than are reported with the injection treatment of varicose veins. They state that they use the high ligation plus the injection treatment in these cases. In the same paper they cite Westerborn's statistics on the comparative mortality rates with the various types of treatment, which show a mortality of 0.26 per cent with surgical treatment alone, 0.33 per cent with high ligation plus the injection treatment and only 0.036 per cent with the injection treatment alone. These statistics, which I am convinced will check favorably with the average reliable statistics, show a ten times greater mortality rate with high

Pulmonary embolism following the injection treatment of varicose veins: Dean, G. O., and Dulin, J. W.: J. A. M. A. 114: 1344, 1940

Pulmonary embolism following the injection treatment of varicose veins: Dean, G. O., and Dulin, J. W.: J. A. M. A. 114: 1344, 1940

The injection treatment of varicose veins in a state hospital

1. Forty-two patients with varicose veins were treated by the injection method. 2. The injection technique is a relatively simple procedure. 3. Seven of eight ulcers treated healed over completely, and it was felt that by treatment of the larger veins new ulcer formation was prevented. 4. Patients with edema and eczema showed improvement. 5. Sloughs and reactions were rare and there were no serious complications. 6. Sodium morrhuate was the solution of choice because of the excellent results obtained with it, the small amount of solution necessary, and the ease of administration. 7. Recurrences are infrequent and should not be confused with the formation of other, new varicose veins. 8. Some patients showed an increased ability to adjust in the hospital, with elimination of disfiguring veins and relief from pain and fatigue. 9. Transference is more easily established between patient and physician by attention to the patient's physical disabilities, including those of lesser severity. 10. Because of the multiplicity of etiologic factors in the production of many psychoses, the removal of even a minor one is a step toward restoration of normalcy.

Injection Treatment of Varicose Veins

Injection Treatment of Varicose Veins

Treatment of varicose veins

T HE injection treatment of varicose veins has enjoyed a wave of popuIarity in the past few years and as a resuIt surgica1 procedures have faIIen into discard. This is IargeIy due to the fact that the sclerosing soIutions have become more efficient, the injection treatment seemed to be Iess formidabIe than surgery, and hospitalization couId be avoided. The test of time has shown that permanent resuIts were not being obtained and more radica1 measures than the injection of scIerosing soIutions are required for permanent reIief. The treatment of varicose veins by Iigation and injection is known to have been performed over thirty years ago. This form of therapy, however, was not emphasized until recentIy and is now recognized as the most reIiabIe method of obtaining permanent cures.1,2,3,4 There are some cases which respond to injection treatment aIone, but these are in the minority. Varicosities generaIIy are stiI1 being under-treated. Modern treatment should be more thorough treatment, with fewer recurrences. To treat successfuIIy varicose veins and their compIications the extent of the underIying disease must be recognized. No form of therapy shouId be instituted until the efficiency of the vaIves of the saphenous and communicating veins and the patency of the deep circulation is known and arteria1 disease of the Iower extremities ruIed out. These factors are determined as folIows : A. Tests to Determine the Valvular Competence of the Sapbenous Veins and Its Communicating Branches with the Deep Circulation. I. Schwartz test :5 The flat portions of the fingers of one hand are pIaced aIong the usua1 course of the saphenous vein in the thigh, and the vein is sharpIy tapped on one of its varicosities CLAYTON SHIRLEY, M.D., F.A.C.S.

Allergic manifestations with injection treatment of varicose veins: Shelley, H. J.: J. A. M. A. 112: 1792, 1939

Malignant catarrhal fever (MCF), a frequently fatal herpesviral disease primarily of ruminant species, has been sporadically reported in pigs. All cases of naturally occurring porcine MCF reported to date have been linked to ovine herpesvirus 2 (OvHV-2), a gammaherpesvirus in the genus Macavirus carried by sheep. Experimental induction of MCF by aerosolization of the virus in nasal secretions collected from infected sheep has been successful in bison, cattle and rabbits. The goals of this study were to determine the susceptibility of pigs to MCF following experimental intranasal inoculation of OvHV-2, and to characterize the disease. Twelve pigs in four groups were nebulized with 105, 106, 107, or 108 DNA copies of OvHV-2 from sheep nasal secretions. Three control pigs were nebulized with nasal secretions from uninfected sheep. Three additional pigs were inoculated intravenously with 107 DNA copies of OvHV-2 to evaluate this route of infection with cell-free virus. Seven of twelve intranasally challenged pigs became infected with OvHV-2. Five of these seven, all in higher dose groups, developed MCF. Lesions resembled those reported in natural cases of porcine MCF. The most striking and consistent histological lesions were in trachea, lung, kidney and brain. These comprised mucopurulent tracheitis, interstitial pneumonia, necrotizing arteritis–periarteritis, and nonpurulent meningoencephalitis. No infection was established in the intravenously challenged or control groups. The study showed that MCF can be experimentally induced in pigs by aerosol challenge using sheep nasal secretions containing OvHV-2. Domestic pigs are a natural clinically susceptible host for sheep-associated MCF. They represent a useful, cost-effective model for MCF research.