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Harada F, Kodashima S, Ikusaka K, Aoki N, Shimizu Y, Honda T, Sakurai M, Maruyama K, Aoyagi H, Isono A, Miura R, Abe K, Arizumi T, Asaoka Y, Yamamoto T, Tanaka A. Prophylactic effect of compression stockings for elevated D-dimer levels following endoscopic submucosal dissection. DEN OPEN 2025; 5:e405. [PMID: 39011514 PMCID: PMC11248715 DOI: 10.1002/deo2.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/16/2024] [Accepted: 06/27/2024] [Indexed: 07/17/2024]
Abstract
Objectives A relationship between endoscopic submucosal dissection (ESD) and deep vein thrombosis has been recognized. We previously reported that a high corrected midazolam dose (total midazolam dose/initial dose of midazolam used to induce sedation) is related to elevated D-dimer levels after ESD. In this study, the effect of compression stockings (CSs) in preventing thrombosis following ESD under sedation was evaluated by measuring D-dimer levels before and after ESD. Methods The participants were patients who underwent ESD for upper gastrointestinal tumors during the period between April 2018 and October 2022. Patients with pre-ESD D-dimer levels ≥1.6 µg/m and patients with corrected midazolam doses ≤3.0 were excluded. A retrospective investigation of the relationship between CS use and high post-ESD D-dimer levels (difference in D-dimer levels ≥1.0 µg/mL between before and after ESD) was conducted. Results There were 27 patients in the non-CS group (NCS) and 33 patients in the CS group. The number of patients with high post-ESD D-dimer levels was 13 (48.2%) in the non-CS group and six (18.2%) in the CS group; the number in the CS group was significantly lower (p = 0.024). On logistic regression analysis, a relationship was seen between the wearing of CSs and a lower number of patients with high post-ESD D-dimer levels (odds ratio 0.24, 95% confidence interval 0.08-0.79, p = 0.019). Conclusion Wearing CSs was related to a lower risk of high post-ESD D-dimer levels. This result suggests that thrombus formation is a cause of elevated D-dimer levels after ESD.
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Affiliation(s)
- Fumito Harada
- Department of MedicineTeikyo University School of MedicineTokyoJapan
- Department of the GastroenterologyAgeo Central General HospitalSaitamaJapan
| | - Shinya Kodashima
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Ken Ikusaka
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Naoaki Aoki
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Yuki Shimizu
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Taku Honda
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Miyoko Sakurai
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Kyohei Maruyama
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Hitoshi Aoyagi
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Akari Isono
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Ryo Miura
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Koichiro Abe
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Toshihiko Arizumi
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | - Yoshinari Asaoka
- Department of MedicineTeikyo University School of MedicineTokyoJapan
| | | | - Atsushi Tanaka
- Department of MedicineTeikyo University School of MedicineTokyoJapan
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Hurwitz DJ, Kruchevsky D. Interplay of Oblique Flankplasty with Vertical Medial Thighplasty. Clin Plast Surg 2024; 51:135-146. [PMID: 37945070 DOI: 10.1016/j.cps.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
After 25 years' experience, the authors present the senior author's current integration of lower body lift with vertical medial thighplasty. Mostly, oblique flankplasty with lipoabdominoplasty (OFLA) has replaced the traditional transverse posterior lower body lift and abdominoplasty due to improved esthetics and lower rate of complications. OFLA proceeds either immediately or as a first stage to the medially based reduction of thighs. L-vertical medial thighplasty, facilitated by excision site liposuction and scalpel assisted skin avulsion, is our preferred complimentary operation for predictable results and low rate of complications.
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Affiliation(s)
- Dennis J Hurwitz
- Hurwitz Center for Plastic Surgery, 3109 Forbes Avenue, Suite 500, Pittsburgh, PA 15213, USA; University of Pittsburgh.
| | - Dani Kruchevsky
- Hurwitz Center for Plastic Surgery, 3109 Forbes Avenue, Suite 500, Pittsburgh, PA 15213, USA
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Palmieri A, Hicks V, Aikman N, Borowsky M, Haggerty A, ElSahwi K. Extended Venous Thromboembolism Prophylaxis after Robotic Staging for Endometrial Cancer. South Med J 2023; 116:790-794. [PMID: 37788812 DOI: 10.14423/smj.0000000000001611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Our objectives were to estimate the incidence of venous thromboembolism (VTE) after robotic staging for endometrial cancer and to compare the incidence of VTE in patients who received a single dose of preoperative prophylaxis of enoxaparin with those who received extended postoperative prophylaxis. METHODS This study is a retrospective chart review of patients who underwent robot-assisted surgical staging for endometrial cancer. Patients were categorized into two groups: preoperative prophylaxis (PP), patients who received a single dose of enoxaparin preoperatively, and extended prophylaxis (EP), patients who received 28 days of enoxaparin postoperatively. RESULTS In total, 148 patients were included, with 117 patients in the PP group and 31 patients in the EP group. The overall incidence of VTE within 30 days postoperatively was 0.67%. No significant difference was found between the PP and the EP groups (0.9% and 0%, respectively; P = 1.00). Most patients in the cohort had endometrioid adenocarcinoma (78%) with low-grade disease (70%), although there were a greater number of patients in the PP group with uterine serous carcinoma compared with the EP group (17% vs 10%; P = 0.034). The PP group had higher estimated blood loss (106 vs 81 mL; P = 0.009) and longer operative times (178 vs 151 min; P = 0.028) compared with the EP group. Significantly more patients in the PP group underwent lymph node dissection compared with the EP group (32% vs 7%; P = 0.008). CONCLUSIONS The incidence of VTE following robot-assisted surgical staging for endometrial cancer in this study was 0.67%. No significant difference was found in VTE incidence between the PP group compared with the EP group. Mechanical prophylaxis plus a single dose of preoperative pharmacologic prophylaxis may suffice for low-risk patients following robotic surgical staging for endometrial cancer.
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Affiliation(s)
| | | | | | | | | | - Karim ElSahwi
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey
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Wei Q, Wei ZQ, Jing CQ, Li YX, Zhou DB, Lin MB, He XL, Li F, Liu Q, Zheng JY, Wang GY, Tu SL, Wang ZJ, Li A, Xiao G, Zhuang J, Bai L, Huang H, Li Y, Song W, Liang ZL, Shen ZL, Liu FL, Dai Y, Zhou XJ, Dong M, Wang H, Qiu J, Zhou L, Li XX, Wang ZQ, Zhang H, Wang Q, Pang MH, Wei HB, Hu ZQ, Yan YD, Che Y, Gu ZC, Yao HW, Zhang ZT. Incidence, prevention, risk factors, and prediction of venous thromboembolism in Chinese patients after colorectal cancer surgery: a prospective, multicenter cohort study. Int J Surg 2023; 109:3003-3012. [PMID: 37338597 PMCID: PMC10583908 DOI: 10.1097/js9.0000000000000553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a common and serious complication after colorectal cancer (CRC) surgery. Few large-sample studies have reported VTE incidence and management status after CRC surgery in China. This study aimed to investigate the incidence and prevention of VTE in Chinese patients after CRC surgery, identify risk factors for developing VTE, and construct a new scoring system for clinical decision-making and care planning. METHODS Participants were recruited from 46 centers in 17 provinces in China. Patients were followed up for 1 month postoperatively. The study period was from May 2021 to May 2022. The Caprini score risk stratification and VTE prevention and incidence were recorded. The predictors of the occurrence of VTE after surgery were identified by multivariate logistic regression analysis, and a prediction model (CRC-VTE score) was developed. RESULTS A total of 1836 patients were analyzed. The postoperative Caprini scores ranged from 1 to 16 points, with a median of 6 points. Of these, 10.1% were classified as low risk (0-2 points), 7.4% as moderate risk (3-4 points), and 82.5% as high risk (≥5 points). Among these patients, 1210 (65.9%) received pharmacological prophylaxis, and 1061 (57.8%) received mechanical prophylaxis. The incidence of short-term VTE events after CRC surgery was 11.2% (95% CI 9.8-12.7), including deep venous thrombosis (DVT) (11.0%, 95% CI 9.6-12.5) and pulmonary embolism (PE) (0.2%, 95% CI 0-0.5). Multifactorial analysis showed that age (≥70 years), history of varicose veins in the lower extremities, cardiac insufficiency, female sex, preoperative bowel obstruction, preoperative bloody/tarry stool, and anesthesia time at least 180 min were independent risk factors for postoperative VTE. The CRC-VTE model was developed from these seven factors and had good VTE predictive performance ( C -statistic 0.72, 95% CI 0.68-0.76). CONCLUSIONS This study provided a national perspective on the incidence and prevention of VTE after CRC surgery in China. The study offers guidance for VTE prevention in patients after CRC surgery. A practical CRC-VTE risk predictive model was proposed.
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Affiliation(s)
- Qi Wei
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing
| | - Zheng-Qiang Wei
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing
| | - Chang-Qing Jing
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province
| | - Yong-Xiang Li
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province
| | - Dong-Bing Zhou
- Department of Gastrointestinal Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong, Sichuan Province
| | - Mou-Bin Lin
- Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai
| | - Xian-Li He
- Department of General Surgery, Tangdu Hospital, The Air Force Medical University, Xi’an, Shannxi Province
| | - Fan Li
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing
| | - Qian Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Jian-Yong Zheng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Air Force Military Medical University, Xi’an, Shaanxi Province
| | - Gui-Ying Wang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province
| | - Shi-Liang Tu
- General Surgery, Cancer Center, Department of Colorectal Surgery, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province
| | - Zhen-Jun Wang
- Department of General Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing
| | - Ang Li
- Department of General Surgery, Xuanwu Hospital Capital Medical University, Beijing
| | - Gang Xiao
- Department of Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology, Beijing
| | - Jing Zhuang
- Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province
| | - Lian Bai
- Department of Gastrointestinal Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing
| | - He Huang
- Department of Gastrointestinal Surgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province
| | - Yong Li
- Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital, Guangzhou, Guangdong Province
| | - Wu Song
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province
| | - Zhong-Lin Liang
- Department of Colorectal and Anal Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Zhan-Long Shen
- Department of Gastroenterological Surgery, Peking University People’s Hospital, Beijing
| | - Fan-Long Liu
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Yong Dai
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong Province
| | - Xiao-Jun Zhou
- Department of General Surgery, First Affiliated Hospital of Soochow University, Soochow, Jiangsu Province
| | - Ming Dong
- Department of Gastrointestinal Surgery, The First Hospital of China Medical University, Shenyang, Liaoning Province
| | - Hui Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province
| | - Jian Qiu
- Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi Province
| | - Lei Zhou
- Department of General Surgery, China-Japan Friendship Hospital, Beijing
| | - Xin-Xiang Li
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai
| | - Zi-Qiang Wang
- Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province
| | - Hong Zhang
- Department of Colorectal Oncology, Fourth General Surgery Department, Shengjing Hospital, China Medical University, Shenyang, Liaoning Province
| | - Quan Wang
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin Province
| | - Ming-Hui Pang
- Department of Geriatric Surgery; Department of Gastrointestinal Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan Province
| | - Hong-Bo Wei
- Department of Gastrointestinal Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province
| | - Zhi-Qian Hu
- Department of Gastrointestinal Surgery, Tongji Hospital, Medical College of Tongji University, Shanghai
| | - Yi-Dan Yan
- Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Yan Che
- NHC Key Lab of Reproduction Regulation, Shanghai Institute for Biomedical and Pharmaceutical Technologies, Shanghai, People’s Republic of China
| | - Zhi-Chun Gu
- Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai
| | - Hong-Wei Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing
| | - Zhong-Tao Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing
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Carnevale Pellino V, Gatti A, Vandoni M, Patanè P, Febbi M, Ballarin S, Cavallo C, Marin L. Pneumatic Compression Combined with Standard Treatment after Total Hip Arthroplasty and Its Effects on Edema of the Operated Limb and on Physical Outcomes: A Pilot Clinical Randomized Controlled Study. J Clin Med 2023; 12:4164. [PMID: 37373857 DOI: 10.3390/jcm12124164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a lower quality of life. For these reasons, the aim of this study (NCT05312060) was to evaluate the effectiveness of a specific intermittent leg pneumatic compression on lower limb edema and physical outcomes in patients after total hip arthroplasty, compared to standard conservative treatment. A total of 47 patients were enrolled and randomly allocated into two groups: the pneumatic compression group (PG = 24) and the control group (CG = 23). The CG performed the standard venous thromboembolism therapy, which included pharmacological prophylaxis, compressive stockings, and electrostimulation, while the PG combined pneumatic compression with standard VTE therapy. We evaluated thigh and calf circumferences, knee and ankle ranges of motion, pain, and walking autonomy. Our results showed a greater reduction in thigh and calf circumferences for PG (p < 0.001), while other outcomes were similar for the two groups (p > 0.05). The combination of standard therapy with pneumatic leg compression was more effective at reducing lower limb edema and thigh and calf circumferences than standard treatment. Our results suggest that pressotherapy treatment is a valuable and efficient option for managing lower limb edema after THA.
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Affiliation(s)
- Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Pamela Patanè
- Industrial Engineering Department, University of Tor Vergata, 00133 Rome, Italy
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Massimiliano Febbi
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
| | - Stefania Ballarin
- Laboratory for Rehabilitation Medicine and Sport (LARMS), 00133 Rome, Italy
| | - Caterina Cavallo
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 4530 Luxembourg, Luxembourg
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Research, ASOMI College of Sciences, 2080 Marsa, Malta
- Department of Rehabilitation, Istituto di Cura "Città di Pavia", 27100 Pavia, Italy
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Schmidt SCE, Sell S, Woll A. The Use of Compression Stockings to Reduce Water Retention in the Legs During Gaming and Esports: Randomized Controlled Field Study. Interact J Med Res 2022; 11:e25886. [PMID: 36173666 PMCID: PMC9562085 DOI: 10.2196/25886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 11/27/2021] [Accepted: 12/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background With the increasing digitalization of daily life, internet-based entertainment such as gaming and streaming has advanced to one of the megatrends of the 21st century. Besides offering a multitude of controversially discussed opportunities for entertainment and social interaction, there is reasonable concern about health issues caused by the absence of physical activity among activities linked to gaming and streaming. Objective The aim of this study is to compare the water balance of recreational gamers with and those without compression stockings during a gaming event. Methods We measured body composition and water balance with 8-electrode bioelectrical impedance analysis among 46 recreational gamers with an average age of 27.1 (SD 6.5) years (5/46, 11% women and 41/46, 89% men) before and after 24 hours at a gaming event. Of the 46 gamers, 23 (50%) gamers wore compression stockings for the duration of the study. Results Our study shows that prolonged gaming and associated behaviors during a 24-hour time frame lead to an increase in total body water (+0.76 L; P<.001) and a decrease of phase angle in the lower extremities (−0.47°; P<.001) but not in the upper extremities (+0.09°; P=.80), when no compression is used. Gamers using compression socks did not show any significant negative effects on their body composition. Conclusions Prolonged gaming and streaming are serious risk factors for diseases associated with water retention in the legs, and these risks can be measured by bioelectrical impedance and reduced by wearing compression stockings. We conclude that these findings should be discussed and replicated in larger studies and that there is a considerably large market for compression stockings among gamers and live streamers.
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Affiliation(s)
| | - Stefan Sell
- Joint Center Black Forest, Hospital Neuenbuerg, Neuenbuerg, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Jiang T, Song K, Yao Y, Zhuang Z, Shen Y, Li X, Xu Z, Jiang Q. Thigh-length graduated compression stocking cannot increase blood velocity of the common femoral vein in patients awaiting total hip arthroplasty. BMC Musculoskelet Disord 2022; 23:765. [PMID: 35948890 PMCID: PMC9367155 DOI: 10.1186/s12891-022-05737-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives Graduated compression stocking (GCS) is one of the mechanical prophylaxes commonly used for deep vein thrombosis (DVT). The present study was designed to observe the effects of graduated compression stockings on the vein deformation and hemodynamics of lower limbs in patients awaiting total hip arthroplasty (THA). Methods The lower extremity veins of 22 patients awaiting THA were examined by ultrasound, when they rested in supine position with or without thigh-length GCS. The deformation parameters we measured included antero-posterior (AP) diameters, latero-medial (LM) diameters, and cross-sectional area (CSA) of great saphenous vein (GSV), posterior tibial vein (PTV), popliteal vein (PV), gastrocnemius vein (GV), and superficial femoral vein (SFV). We measured peak velocity and mean velocity of GSV, common femoral vein (CFV), junction of GSV and CFV to represent for hemodynamics of veins. Results Significant compression was observed in almost all measured veins with the use of thigh-length GCS, while it was unable to significantly compress GSV in latero-medial diameter. The mean latero-medial diameter reductions for GSV, PTV, GV, PV and SFV were 19.4, 30.2, 43.2, 29.7 and 20.4%, respectively. GCS significantly compressed antero-posterior diameter of GSV, PTV, GV, PV and SFV by 43.4, 33.3, 42.1, 37.5, and 27.8%, respectively. The mean reduction of cross-section area was 44.8% for GSV, 49.6% for PTV, 60.0% for GV, 57.4% for PV, and 36.2% for FV. No significant changes were observed in the mean blood velocity of GSV, CFV, and junction. GCS was able to significantly reduce peak velocity of CFV (17.6 ± 5.6 cm/s to 16.1 ± 6.0 cm/s) and junction (23.3 ± 9.5 cm/s to 21.3 ± 9.7 cm/s), while it did not change the peak velocity of GSV. Conclusion Thigh-length GCS is sufficient to compress lower extremity veins in patients awaiting THA in supine position with the greatest compression in GV, while it was unable to significantly increase blood velocity of common femoral vein or GSV. GCS may prevent DVT through more than simply increasing blood flow. Further studies are needed to determine the specific effects of GCS.
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Affiliation(s)
- Tao Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China
| | - Kai Song
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yao Yao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Zaikai Zhuang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Ying Shen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Xinhua Li
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Zhihong Xu
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
| | - Qing Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 210008, Nanjing, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
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8
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Sakai K, Takahira N, Tsuda K, Akamine A. A novel device for lower leg intermittent pneumatic compression synchronized with active ankle exercise for prevention of deep vein thrombosis. Phlebology 2022; 37:507-515. [DOI: 10.1177/02683555221089618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Intermittent pneumatic compression devices (IPCDs) and active ankle exercises have been shown to be efficacious in preventing venous thromboembolism (VTE) by increasing venous flow velocity and volume. However, IPCDs are expensive and require electricity; therefore, they cannot be used in the event of power loss. We developed a non-powered device that provides lower leg intermittent pneumatic compression synchronized with AAEs (LISA) and compared its efficacy with AAEs alone in increasing the peak velocity in the femoral vein. Methods The study population consisted of 20 healthy younger men and 20 healthy older men who performed AAE every 2 s in a sitting posture under four conditions: AAE with LISA (AAE+LISA), AAE alone (AAE), AAE with IPCD, and AAE with a graduated compression stocking. Results The PVs under all conditions were significantly higher than those at rest. The PVs in the AAE+LISA condition were significantly higher than those in the AAE alone condition in both younger and older groups (both p < .001). Conclusions AAE with LISA significantly increased the PV, suggesting that LISA might be useful for preventing DVT.
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Affiliation(s)
- Kenta Sakai
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Rehabilitation Center, St Marianna University School of Medicine, Kawasaki-shi, Japan
| | - Naonobu Takahira
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Department of Orthopaedic Surgery, Kitasato University Graduate School of Medical Sciences, Sagamihara-shi, Japan
- Physical Therapy Course, Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara-shi, Japan
| | - Kouji Tsuda
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan
| | - Akihiko Akamine
- Department of Pharmacy, Kitasato University Hospital, Sagamihara-shi, Japan
- Orthopedic Surgery, Clinical Medicine, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
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9
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Pretorius J, Nemat N, Azeem I, Shaju T, Nadeem S, Hammad Y. Is aspirin still relevant as a single pharmacological agent for venous thromboembolism prophylaxis post hip and knee arthroplasty surgery: A retrospective review. SICOT J 2022; 8:28. [PMID: 35766820 PMCID: PMC9241622 DOI: 10.1051/sicotj/2022029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/12/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Aspirin is widely used for the prevention of venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA). It is well-established that the bleeding and wound complication risk for aspirin is low or equivalent to the other anticoagulant agents, but there is still ongoing controversy regarding the efficacy of aspirin for VTE prophylaxis. The current HSE (2012) guideline suggests 72 h of enoxaparin and 4 weeks of Aspirin therapy. But is this practice still relevant with more recent guidelines, NICE (2021) and SIGN (2014) suggesting that Aspirin is not recommended as a single pharmacological agent for VTE prophylaxis. Method: A Retrospective review was performed of a single centre, between January 2016 and May 2021 assessing for symptomatic VTE post-THA and TKA. All the patients received enoxaparin and aspirin as per the HSE guidelines. Using NIMIS we assessed which patients received a workup for potential symptomatic VTE and who had a confirmed VTE within 3 months post-surgery. The secondary outcome was mortality within 3 months post-surgery. Results: A total of 1178 patients (721 undergoing THR and 457 undergoing TKR) were included in the study. The number of patients who received a workup for potential symptomatic VTE was 124 of 1178 (10.53%). VTE occurred in 13 of 721 patients (1.80%) of the THR patients and 1 of 457 (0.22%) of the TKR patients, and a total of 14 of 1178 patients (1.19%). Of these 7 (0.59%) patients developed a DVT and 7 (0.59%) a PE. No patients suffered a fatal pulmonary embolism within 90 days of index surgery nor any other cause of mortality. Conclusion: Aspirin is not only still relevant but can be considered as one of the most optimal pharmacological agents in preventing VTE after THA and TKA.
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Affiliation(s)
- Jacques Pretorius
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
| | - Nouman Nemat
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
| | - Imran Azeem
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
| | - Tony Shaju
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
| | - Sayed Nadeem
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
| | - Yasir Hammad
- Letterkenny University Hospital, Kilmacrennan Road, Ballyboe, Letterkenny, County Donegal F92AE81, Ireland
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10
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Zhuang Z, Ai D, Yao Y, Zheng L, Qin J, Chen D, Chai S, Lu J, Jiang Q, Li X. The changes of the calf-vein deformation and femoral vein peak velocity during ankle pump exercise with or without graduated compression stockings. BMC Musculoskelet Disord 2022; 23:435. [PMID: 35538467 PMCID: PMC9088108 DOI: 10.1186/s12891-022-05400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/25/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives To analyze the changes of lower limb hemodynamics parameters before and after wearing graduated compression stockings (GCS) during ankle pump exercise in patients preparing for arthroplastic surgery. Method The leg veins of 16 patients awaiting arthroplasty were analyzed using a Sonosite M-Turbo ultrasound system during ankle pump exercise with or without GCS. The age of them was 70 ± 7 years (mean ± SD) (range 56—82 years) and body mass index was 25.8 ± 3.0 kg/m2 (range 18.0—30.5 kg/m2). Measured data including the cross-sectional area (CSA), anteroposterior (AP) diameter and lateromedial (LM) diameter of the soleus vein (SV), posterior tibial vein (PTV) and great saphenous vein (GSV). Additionally, the peak velocities of femoral vein (FV) were also measured. Results GCS could significantly decrease the cross-sectional area of SV, PTV and GSV in supine position at rest and maximum ankle plantar flexion. But the compression effect of GCS to SV and GSV was not observed during maximum ankle dorsiflexion. It was found that GCS application reduced the peak flow velocity of the femoral vein from 61.85 cm/s (95% CI = 50.94–72.75 cm/s) to 38.01 cm/s (95% CI = 28.42–47.59 cm/s) (P < 0.001) during ankle plantar flexion and decreased the femoral vein in these patients from 80.65 cm/s (95% CI = 70.37–90.92 cm/s) to 51.15 cm/s (95% CI = 42.58–59.73 cm/s) (P < 0.001) during ankle dorsiflexion. But this effect was not significant in supine position at rest. Conclusions GCS could significantly reduce the peak flow velocity of the femoral vein during ankle pump exercise in the patients preparing for arthroplastic surgery.
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Affiliation(s)
- Zaikai Zhuang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Dongmei Ai
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yao Yao
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Liming Zheng
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Jianghui Qin
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Dongyang Chen
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Senlin Chai
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Jun Lu
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China. .,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China.
| | - Xinhua Li
- State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China. .,Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing, Jiangsu, People's Republic of China.
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11
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Zhuang Z, Wang Y, Yao Y, Shen Y, Chen D, Jiang Q. The impact of graduated compression stockings on calf-vein deformation and blood velocity in patients awaiting total knee arthroplasty. BMC Musculoskelet Disord 2021; 22:722. [PMID: 34425810 PMCID: PMC8381553 DOI: 10.1186/s12891-021-04603-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 08/09/2021] [Indexed: 02/02/2023] Open
Abstract
Objectives This study was designed to explore venous deformation of the lower extremities and the changes in venous hemodynamics in supine position before and after wearing graduated elastic stockings in patients awaiting total knee arthroplasty (TKA). Method The leg veins of 21 elderly patients awaiting TKA were imaged in the supine position with and without knee-length graduated compression stockings (GCS) according to a fixed protocol. Measured parameters including the lateromedial (LM) diameter, anteroposterior (AP) diameter, and cross-sectional area (CSA) of the great saphenous vein (GSV), gastrocnemius vein (GV), soleus vein (SV), posterior tibial vein (PTV), fibular vein (FV), and anterior tibial vein (ATV). In addition, the mean and maximum velocities of the popliteal vein (PV) and superficial femoral vein (FSV) were measured. Results GCS-related compression was observed for all the measured veins. Maximal reduction was observed for the GV and SV, whereas the GSV exhibited the lowest degree of GCS-related compression. The mean cross-sectional area reduction values associated with GCS were 33.1 ± 41.2 % for the GSV, 94.8 ± 11.1 % for the GV, and 85.6 ± 20.3 % for the SV, while the mean reduction of anteroposterior diameter was 18.1 ± 34.5 % for the GSV, 89.0 ± 22.5 % for the GV, and 72.9 ± 35.1 % for the SV, and the mean reduction of the lateromedial diameter was 25.9 ± 36.4 % for the GSV, 89.6 ± 19.6 % for the GV, 78.2 ± 28.3 % for the SV. No significant GCS-related changes in blood velocity in the superficial femoral veins or popliteal veins were detected. Conclusions For elderly patients awaiting TKA, knee-length GCS can significantly reduce calf vein dilation while at rest in the supine position, with the greatest reductions being observed for the soleus and gastrocnemius veins. These data might help provide a theoretical basis for the GCS in reducing incidence of deep vein thrombosis in patients undergoing TKA.
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Affiliation(s)
- Zaikai Zhuang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China
| | - Yexian Wang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Yao Yao
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Ying Shen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China.,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China
| | - Dongyang Chen
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
| | - Qing Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, People's Republic of China. .,State Key Laboratory of Pharmaceutical Biotechnology, Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, Jiangsu, People's Republic of China.
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12
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Customised pressure profiles of made-to-measure sports compression garments. SPORTS ENGINEERING 2021. [DOI: 10.1007/s12283-021-00350-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThe purpose of this study was to make made-to-measure compression garments that elicit pressures within and below clinical standards. The study also examined whether pressures and gradients can be replicated within and between participants’ legs, and between separate compression garment conditions. Ten males volunteered to participate. Based on three-dimensional scans of the participants’ lower body, three different made-to-measure garments were manufactured: control, symmetrical and asymmetrical. Garment pressures were assessed from the malleolus to the gluteal fold using a pressure monitoring device. A root mean squared difference analysis was used to calculate the in vivo linear graduation parameters. Linear regression showed that peak pressure at the ankle in the left and right leg were: control garment, 13.5 ± 2.3 and 12.9 ± 2.6; asymmetrical garment, 12.7 ± 2.5 and 26.3 ± 3.4; symmetrical garment, 27.7 ± 2.2 and 27.5 ± 1.6 (all mmHg, mean ± standard deviation). Pressure reduction from the ankle to the gluteal fold in the left and right leg were: control, 8.9 ± 3.5 and 7.4 ± 3.0; asymmetrical, 7.8 ± 3.9 and 21.9 ± 3.2; symmetrical, 25.0 ± 4.1 and 22.3 ± 3.6 (all mmHg, mean ± standard deviation). Made-to-measure compression garments can be made to elicit pressures within and below clinical standards, and to elicit equivalent pressures and gradients in different participants.
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13
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Poignard M, Guilhem G, de Larochelambert Q, Montalvan B, Bieuzen F. The Impact of Recovery Practices Adopted by Professional Tennis Players on Fatigue Markers According to Training Type Clusters. Front Sports Act Living 2020; 2:109. [PMID: 33345098 PMCID: PMC7739815 DOI: 10.3389/fspor.2020.00109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/22/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: Modern tennis players face congested schedules that force the adoption of various recovery strategies. Thus, recovery must be fine-tuned with an accurate quantification of its impacts, especially with regards to training-induced fatigue. The present study aimed to examine the training type clusters and recovery practices adopted by elite tennis players under ecological training conditions. The respective impacts of training type clusters and recovery techniques on subjective variables, which reflect the players' recovery perceptions, were subsequently determined. Methods: During 15 consecutive months, a total of 35 elite tennis players filled out questionnaires to report their daily training load, training session content, adopted recovery modalities after training, and perceived recovery. Results: The hierarchical analysis identified three clusters: “combined tennis and S&C training,” “predominant tennis training” and “predominant S&C training.” Muscle soreness and perceived fatigue were not significantly different among these three clusters (p = 0.07–0.65). Across the 146 recorded training and recovery sessions, players primarily employed a combination of 2 or 3 modalities, with cooling strategies being the most widely used technique (87.6%). Mixed linear models revealed that independent of training clusters, cooling strategies significantly reduced muscle soreness (Δmuscle soreness: β = −1.00, p = 0.02). Among the cooling techniques used, whole-body cryotherapy induced a greater perceived recovery than cold-water immersion (p = 0.02). Conclusion: These results showed that perceived recovery was not sensitive to training clusters or the associated acute training load. However, cooling strategies were relevant for the alleviation of tennis training-induced soreness. This study represents an initial step toward a periodized approach of recovery interventions, based on the interactions between training load, training contents, and perceived recovery.
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Affiliation(s)
- Mathilde Poignard
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France.,French Tennis Federation, Paris, France
| | - Gaël Guilhem
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), Paris, France
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14
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Lee DCW, Ali A, Sheridan S, Chan DKC, Wong SHS. Wearing Compression Garment Enhances Central Hemodynamics? A Systematic Review and Meta-Analysis. J Strength Cond Res 2020; 36:2349-2359. [PMID: 33065703 DOI: 10.1519/jsc.0000000000003801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lee, DCW, Ali, A, Sheridan, S, Chan, DKC, and Wong, SHS. Wearing compression garment enhances central hemodynamics? a systematic review and meta-analysis . J Strength Cond Res XX(X): 000-000, 2020-Compression garments (CG) are believed to enhance exercise performance and recovery by improving central hemodynamic responses. However, evidence is inconclusive. We performed a systematic review and meta-analysis to determine the effect of wearing CG at rest or after a physiological challenge on central hemodynamic responses, including cardiac output, stroke volume (SV), heart rate (HR), systolic blood pressure, diastolic blood pressure (DBP), and systemic vascular resistance in healthy individuals. The English language searches of the electronic databases SPORTDiscus, MEDLINE, and Web of Science were conducted from November 2018-February 2019. The studies involved were limited to the following: (a) original articles; (b) randomized controlled trials; (c) monitoring of central hemodynamic responses (either at rest or after a physiological challenge: maximal exercise or orthostatic challenge); and (d) healthy individuals. Of the 786 studies identified, 12 were included in the systematic review and meta-analysis. Meta-analysis was performed by the restricted maximum likelihood method. The results indicated that the effect size (ES) of wearing CG on improving central hemodynamic responses was large overall (Hedges' g = 0.55) and was large in SV (Hedges' g = 1.09) and HR (Hedges' g = 0.65). Subgroup analysis showed that the ESs in "post-physiological challenge" was large in overall (Hedges' g = 0.98), SV (Hedges' g = 1.78), HR (Hedges' g = 1.10), and DBP (Hedges' g = 0.75). Their ESs in "at rest" were not significant in all central hemodynamic responses, apart from a significant medium ES observed in SV (Hedges' g = 0.44). Healthy individuals who wear CG have marked improvement in central hemodynamic responses, particularly after a physiological challenge. More pronounced effects of CG are observed in increasing SV and reducing HR.
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Affiliation(s)
- Daniel C W Lee
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong.,Elite Training Science and Technology Division, Hong Kong Sports Institute, Hong Kong
| | - Ajmol Ali
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong.,School of Sport, Exercise, and Nutrition, Massey University, Auckland, New Zealand
| | - Sinead Sheridan
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Derwin K C Chan
- Department of Early Childhood Education, Faculty of Education and Human Development, The Education University of Hong Kong, Hong Kong
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
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15
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Santana DC, Emara AK, Orr MN, Klika AK, Higuera CA, Krebs VE, Molloy RM, Piuzzi NS. An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E416. [PMID: 32824931 PMCID: PMC7558636 DOI: 10.3390/medicina56090416] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/16/2022]
Abstract
Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6-1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage.
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Affiliation(s)
- Daniel C. Santana
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Ahmed K. Emara
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Melissa N. Orr
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Alison K. Klika
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Carlos A. Higuera
- Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA;
| | - Viktor E. Krebs
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Robert M. Molloy
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
| | - Nicolas S. Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH 44195, USA; (D.C.S.); (A.K.E.); (M.N.O.); (A.K.K.); (V.E.K.); (R.M.M.)
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16
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Savitch SL, Bauer TM, Alvarez NH, Johnson AP, Yeo TP, Lavu H, Yeo CJ, Winter JM, Merli GJ, Cowan SW. The Pathway to Low Outlier Status in Venous Thromboembolism Events: An Analysis of Pancreatic Surgery in the National Surgical Quality Improvement Program. J Pancreat Cancer 2020; 6:55-63. [PMID: 32642631 PMCID: PMC7337243 DOI: 10.1089/pancan.2020.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose: Our institution's hepatopancreaticobiliary surgery service (HPBS) has demonstrated low rates of venous thromboembolism (VTE). We sought to determine whether the HPBS's regimented multimodal VTE prophylaxis pathway, which includes the use of mechanical prophylaxis, pharmacological prophylaxis, and ambulation, plays a role in achieving low VTE rates. Methods: We compared pancreatic surgeries in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant user file with our institution's data from 2011 to 2016 using univariate, multivariate, and matching statistics. Results: Among 36,435 NSQIP operations, 850 (2.3%) underwent surgery by the HPBS. The HPBS achieved lower VTE rates than the national cohort (2.0% vs. 3.5%, p = 0.018). Upon multivariate analysis, having an operation performed by the HPBS independently conferred lower odds of VTE incidence in the matched cohort (odds ratio = 0.530, p = 0.041). Conclusions: We identified an independent correlation between the HPBS and decreased VTE incidence, which we believe to be due to strict adherence to and team participation in a high risk VTE prophylaxis pathway, including inpatient pharmacological prophylaxis, thromboembolic deterrent stockings, sequential compression devices, and mandatory ambulation.
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Affiliation(s)
- Samantha L Savitch
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Tyler M Bauer
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nkosi H Alvarez
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adam P Johnson
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Theresa P Yeo
- Jefferson Pancreas, Biliary, and Related Cancer Center, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Harish Lavu
- Jefferson Pancreas, Biliary, and Related Cancer Center, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Charles J Yeo
- Jefferson Pancreas, Biliary, and Related Cancer Center, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jordan M Winter
- Jefferson Pancreas, Biliary, and Related Cancer Center, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Geno J Merli
- Division of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Scott W Cowan
- Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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17
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Paciullo F, Bury L, Noris P, Falcinelli E, Melazzini F, Orsini S, Zaninetti C, Abdul-Kadir R, Obeng-Tuudah D, Heller PG, Glembotsky AC, Fabris F, Rivera J, Lozano ML, Butta N, Favier R, Cid AR, Fouassier M, Podda GM, Santoro C, Grandone E, Henskens Y, Nurden P, Zieger B, Cuker A, Devreese K, Tosetto A, De Candia E, Dupuis A, Miyazaki K, Othman M, Gresele P. Antithrombotic prophylaxis for surgery-associated venous thromboembolism risk in patients with inherited platelet disorders. The SPATA-DVT Study. Haematologica 2020; 105:1948-1956. [PMID: 31558677 PMCID: PMC7327644 DOI: 10.3324/haematol.2019.227876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/25/2019] [Indexed: 12/11/2022] Open
Abstract
Major surgery is associated with an increased risk of venous thromboembolism (VTE), thus the application of mechanical or pharmacologic prophylaxis is recommended. The incidence of VTE in patients with inherited platelet disorders (IPD) undergoing surgical procedures is unknown and no information on the current use and safety of thromboprophylaxis, particularly of low-molecular-weight-heparin in these patients is available. Here we explored the approach to thromboprophylaxis and thrombotic outcomes in IPD patients undergoing surgery at VTE-risk participating in the multicenter SPATA study. We evaluated 210 surgical procedures carried out in 155 patients with well-defined forms of IPD (VTE-risk: 31% high, 28.6% intermediate, 25.2% low, 15.2% very low). The use of thromboprophylaxis was low (23.3% of procedures), with higher prevalence in orthopedic and gynecological surgeries, and was related to VTE-risk. The most frequently employed thromboprophylaxis was mechanical and appeared to be effective, as no patients developed thrombosis, including patients belonging to the highest VTE-risk classes. Low-molecular-weight-heparin use was low (10.5%) and it did not influence the incidence of post-surgical bleeding or of antihemorrhagic prohemostatic interventions use. Two thromboembolic events were registered, both occurring after high VTE-risk procedures in patients who did not receive thromboprophylaxis (4.7%). Our findings suggest that VTE incidence is low in patients with IPD undergoing surgery at VTE-risk and that it is predicted by the Caprini score. Mechanical thromboprophylaxis may be of benefit in patients with IPD undergoing invasive procedures at VTE-risk and low-molecular-weight-heparin should be considered for major surgery.
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Affiliation(s)
- Francesco Paciullo
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Italy
| | - Loredana Bury
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Italy
| | - Patrizia Noris
- Department of Internal Medicine, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy
| | - Emanuela Falcinelli
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Italy
| | - Federica Melazzini
- Department of Internal Medicine, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy
| | - Sara Orsini
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Italy
| | - Carlo Zaninetti
- Department of Internal Medicine, IRCCS Policlinico S. Matteo Foundation, University of Pavia, Pavia, Italy
- PhD program in Experimental Medicine, University of Pavia, Pavia, Italy
| | - Rezan Abdul-Kadir
- Haemophilia Centre and Haemostasis Unit, The Royal Free Foundation Hospital and University College London, London, UK
| | - Deborah Obeng-Tuudah
- Haemophilia Centre and Haemostasis Unit, The Royal Free Foundation Hospital and University College London, London, UK
| | - Paula G Heller
- Hematología Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires,
Argentina
- CONICET, Universidad de Buenos Aires, Instituto de Investigaciones Médicas -IDIM-, Buenos Aires, Argentina
| | - Ana C Glembotsky
- Hematología Investigación, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires,
Argentina
- CONICET, Universidad de Buenos Aires, Instituto de Investigaciones Médicas -IDIM-, Buenos Aires, Argentina
| | - Fabrizio Fabris
- Clinica Medica 1 - Medicina Interna CLOPD, Dipartimento Assistenziale Integrato di Medicina, Azienda-Ospedale Università di Padova, Dipartimento di Medicina, Università di Padova, Padova, Italy
| | - Jose Rivera
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguery Centro Regional de Hemodonación, IMIB-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Maria Luisa Lozano
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguery Centro Regional de Hemodonación, IMIB-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Nora Butta
- Unidad de Hematología, Hospital Universitario La Paz-IDIPaz, Madrid, Spain
| | - Remi Favier
- Assistance Publique-Hôpitaux de Paris, Armand Trousseau Children's Hospital, French Reference Centre for Inherited Platelet Disorders, Paris, France
| | - Ana Rosa Cid
- Unidad de Hemostasia y Trombosis, Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - Marc Fouassier
- Consultations d'Hémostase - CRTH, CHU de Nantes, Nantes, France
| | - Gian Marco Podda
- Medicina III, ASST Santi Paolo e Carlo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy
| | - Cristina Santoro
- Hematology, Department of Translational and Precision Medicine, La Sapienza University of Rome, Rome, Italy
| | - Elvira Grandone
- Unità di Ricerca in Aterosclerosi e Trombosi, I.R.C.C.S. "Casa Sollievo della Sofferenza", S. Giovanni Rotondo, Foggia, Italy
- Ob/Gyn Department of the First I.M. Sechenov Moscow State Medical University, Moscow, The Russian Federation
| | - Yvonne Henskens
- Hematological Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Paquita Nurden
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguery Centro Regional de Hemodonación, IMIB-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Barbara Zieger
- Division of Pediatric Hematology and Oncology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Adam Cuker
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katrien Devreese
- Coagulation Laboratory, Department of Laboratory Medicine, Ghent University Hospital, Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | | | - Erica De Candia
- Hemostasis and Thrombosis Unit, Insitute of Internal Medicine, Policlinico Agostino Gemelli Foundation, IRCCS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Arnaud Dupuis
- Université de Strasbourg, Institut National de la Santé et de la Recherche Médicale, Etablissement Français du Sang Grand Est, Unité Mixte de Recherche-S 1255, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Koji Miyazaki
- Department of Transfusion and Cell Transplantation Kitasato University School of Medicine, Sagamihara, Japan
| | - Maha Othman
- Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Paolo Gresele
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Italy
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Espeit L, Lapole T. Effects of graduated compression stockings, local vibration and their combination on popliteal venous blood velocity. Phlebology 2020; 35:505-512. [DOI: 10.1177/0268355520902000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objectives The purpose of this pilot study was to examine and compare the effects of graduated compression stockings, local vibration, and combined graduated compression stockings and local vibration on popliteal venous blood velocity. Method Twenty-four healthy subjects received four 15 min interventions (control, graduated compression stockings alone, local vibration alone, and combined graduated compression stockings and local vibration), while resting inactive in the prone position. Popliteal vein blood velocity was investigated before (PRE) and at the end (POST) of each intervention using Doppler ultrasound. Results At POST, peak velocity was reported to be 26.3 ± 53.5% ( p < 0.05) greater for local vibration than control (CONT). Peak velocity was 46.2 ± 54.6% ( p < 0.001) and 21.1 ± 37.6% ( p < 0.01) higher for graduated compression stockings than CONT and local vibration, respectively. Graduated compression stockings + local vibration presented 64.1 ± 58.0% ( p < 0.001), 38.4 ± 52.4% ( p < 0.001) and 15.0 ± 31.6% ( p < 0.05) greater values than CONT, local vibration and graduated compression stockings, respectively. Conclusions This study demonstrated an increase in popliteal venous blood velocity after graduated compression stockings and local vibration application. Their combination provided the greatest effects.
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Affiliation(s)
| | - Thomas Lapole
- Univ Lyon, UJM Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, Saint-Etienne, France
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Otten R, Stam S, Langhout R, Weir A, Tak I. The effect of compression shorts on pain and performance in male football players with groin pain - A double blinded randomized controlled trial. Phys Ther Sport 2019; 38:87-95. [PMID: 31071660 DOI: 10.1016/j.ptsp.2019.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/21/2019] [Accepted: 04/21/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the effects of compression shorts on pain and performance in football players with groin pain. STUDY DESIGN Double blinded randomized controlled trial. SETTING Soccer pitch. PARTICIPANTS Thirty-four male football players with groin pain. MAIN OUTCOME MEASURES The effect of wearing zoned high compression shorts (ZHC-shorts), non-zoned low compression shorts (NZLC-shorts), and normal sports clothes on pain measured with the Numeric Pain Rating Scale (NPRS) and performance during the Copenhagen 5-s squeeze test (CS), the Illinois Agility test (IAT), and maximum shooting (ST). The effects of wearing ZHC versus NZLC shorts on symptoms were measured using the Hip and groin outcome score (HAGOS) during actual football activities. RESULTS Wearing ZHC-shorts reduced pain during the IAT (1.4, ES = 0.58, p= <0.01) and ST (1.2, ES = 0.47, p= <0.01) compared to wearing normal sports clothes, but did not negatively affect performance. Compared to the baseline HAGOS scores a clinically significant improvement in the symptoms (9.7, ES = 0.63, p= <0.01) and sport/recreation (13.2, ES = 0.68, p = 0.01) subscales was found when wearing the ZHC-short during football activities. CONCLUSION Wearing zoned high compression shorts could be useful in reducing groin pain in football players during their football activities.
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Affiliation(s)
- Roald Otten
- Roald Otten Sportsrehab (Part of J&C Sportsrehab), Amstelveen, the Netherlands.
| | | | - Rob Langhout
- Dutch Institute for Allied Health Care (NPi), Master of Physical Therapy in Sports, Amersfoort, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports, International Olympic Committee Research Center for Prevention of Injury and Protection of Athlete Health, Amsterdam, the Netherlands; Physiotherapy Dukenburg, Nijmegen, the Netherlands; Master Musculoskeletal Therapy (SOMT), Amersfoort, the Netherlands
| | - Adam Weir
- Erasmus MC Center for Groin Injuries, Department of Orthopaedics, Erasmus MC University Medical Centre, Rotterdam, the Netherlands; Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Hospital, Doha, Qatar; Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, the Netherlands
| | - Igor Tak
- Dutch Institute for Allied Health Care (NPi), Master of Physical Therapy in Sports, Amersfoort, the Netherlands; Amsterdam Collaboration on Health and Safety in Sports, International Olympic Committee Research Center for Prevention of Injury and Protection of Athlete Health, Amsterdam, the Netherlands; Physiotherapy Utrecht Oost, Utrecht, the Netherlands; Amsterdam University Medical Centre, Department of Orthopaedics and Sports Traumatology, Amsterdam, the Netherlands; Academic Centre for Evidence Based Sports Medicine (ACES), Amsterdam, the Netherlands
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Tischer TS, Oye S, Lenz R, Kreuz P, Mittelmeier W, Bader R, Tischer T. Impact of compression stockings on leg swelling after arthroscopy - a prospective randomised pilot study. BMC Musculoskelet Disord 2019; 20:161. [PMID: 30967135 PMCID: PMC6456960 DOI: 10.1186/s12891-019-2540-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Post-operative limb swelling may negatively affect the outcome of arthroscopic surgery and prolong rehabilitation. The aim of this pilot study was to evaluate the effect of compression stockings versus no compression on post-operative swelling and pain in the early post-operative phase. Methods A single-centre, randomised controlled trial was performed. Patients who underwent minor knee arthroscopy were randomised to wear class II compression stockings (23-32 mmHg) (CS) or no compression stockings (NCS) immediately post-operatively for ten days. All patients received low molecular weight heparin (LMWH) at prophylactic dosage. The primary outcome variable was post-operative swelling of the limb, quantified by using an optical 3D measurement system (Bodytronic© 600). Pain was rated on a visual analogue scale (VAS). From a total of 76 patients assessed, 19 patients were eligible for final analysis. The trial followed the CONSORT criteria, was registered at clinicaltrial.gov and approved by the local ethics committee. Results The circumference at the middle thigh (cF) was significantly different between groups at day 10 (p = 0.032; circumference − 1.35 ± 2.15% (CS) and + 0.79 ± 3.71% (NCS)). Significant differences were also noted around the knee (cD) at day 10 (p = 0.026) and a significant trend at cD and at the mid lower leg (cB1) at day 4. The volume of the thigh was also different with marked difference between days 1 and 4 between the two groups (p = 0.021; volume + 0.54 ± 2.03% (CS) and + 4.17 ± 4.67 (NCS)). Pain was lower in compression group (not statistically significant). Conclusions Post-operative limb swelling can be reduced significantly by wearing compression stockings in the early post-operative phase when compared to not wearing stockings. This may improve the rehabilitation process after arthroscopic surgery. The optimal duration of compression therapy seems to be between three and ten days. Trial registration clinicaltrials.gov (NCT02096562, date of registration 11.11.2013).
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Affiliation(s)
- Tina S Tischer
- Department of Cardiology, University Medicine Rostock, Rostock, Germany
| | - Sebastian Oye
- Department of Urology, Asklepios Klinik Barmbek, Hamburg, Germany.,Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany
| | - Robert Lenz
- Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany
| | - Peter Kreuz
- Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany.,Department of Orthopedic Surgery, Asklepios Clinic Bad Tölz, Bad Tölz, Germany
| | - Wolfram Mittelmeier
- Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany
| | - Rainer Bader
- Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany
| | - Thomas Tischer
- Department of Orthopedics, University Medicine Rostock, Doberaner Str. 142, 18057, Rostock, Germany.
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Emoto S, Nozawa H, Kawai K, Hata K, Tanaka T, Shuno Y, Nishikawa T, Sasaki K, Kaneko M, Hiyoshi M, Murono K, Ishihara S. Venous thromboembolism in colorectal surgery: Incidence, risk factors, and prophylaxis. Asian J Surg 2019; 42:863-873. [PMID: 30683604 DOI: 10.1016/j.asjsur.2018.12.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/25/2018] [Indexed: 02/07/2023] Open
Abstract
Colorectal surgery is associated with a high risk of perioperative venous thromboembolism (VTE), and this risk is especially high following colorectal cancer resection and surgery for inflammatory bowel disease. Previous analyses of large databases have reported the incidence of postoperative VTE in this population to be approximately 1.1%-2.5%. Therefore, to minimize this risk, patients should be offered appropriate prophylaxis, which may involve a combination of mechanical and pharmacologic prophylaxis with low-dose unfractionated heparin or low molecular weight heparin as recommended by several guidelines. Prior to initiation of treatment, appropriate risk stratification should be performed according to the patients' basic and disease-related as well as procedure-related risk factors, and post-operative factors. Furthermore, a risk-benefit calculation that takes into account patients' VTE and bleeding risk should be performed prior to starting pharmacologic prophylaxis and to help determine the duration of treatment.
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Affiliation(s)
- Shigenobu Emoto
- Department of Surgical Oncology, The University of Tokyo, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Yasutaka Shuno
- Department of Surgical Oncology, The University of Tokyo, Japan
| | | | - Kazuhito Sasaki
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Manabu Kaneko
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Masaya Hiyoshi
- Department of Surgical Oncology, The University of Tokyo, Japan
| | - Koji Murono
- Department of Surgical Oncology, The University of Tokyo, Japan
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Lee DC, Lee SW, Khaw K, Ali A, Sheridan SE, Wong SH. Haemodynamic responses of wearing low-pressure sports compression tights during an orthostatic challenge in healthy individuals. J Sci Med Sport 2018; 21:1062-1067. [DOI: 10.1016/j.jsams.2017.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 11/16/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
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Ansari S, Fung K, MacNeil S, Nichols A, Yoo J, Sowerby L. The use of standardized order sets to improve adherence to evidence-based postoperative management in major head and neck surgery. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S107-S111. [DOI: 10.1016/j.anorl.2018.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/09/2018] [Accepted: 08/13/2018] [Indexed: 11/28/2022]
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Lower Limb Sports Compression Garments Improve Muscle Blood Flow and Exercise Performance During Repeated-Sprint Cycling. Int J Sports Physiol Perform 2018; 13:882-890. [DOI: 10.1123/ijspp.2017-0638] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: Evidence supporting the use of lower-limb compression garments during repeated-sprint exercise (RSE) with short rest periods, where performance will rely heavily on aerobic metabolism, is lacking. Methods: A total of 20 recreationally active participants completed 2 cycling RSE sessions, with and without lower-limb compression tights. The RSE session consisted of 4 sets of 10 × 6-s maximal sprints on a wind-braked cycle ergometer, interspaced by 24 s of recovery between bouts and 2 min of recovery between sets. Muscle oxygen consumption () of, and blood flow (mBF) to, the right vastus lateralis muscle was measured during exercise using near-infrared spectroscopy and venous/arterial occlusions of the right lower limb. Cycling performance, oxygen consumption (), heart rate, and capillary blood samples (lactate, pH, bicarbonate, and base excess) were also measured/taken throughout the session. Results: Compared with control, peak power (40.7 [19.9] W; mean ± 95% confidence intervals) and mBF (0.101 [0.061] mL·min−1·100 g−1) were higher, and heart rate (2 [1] beats/min) was lower, when participants wore compression (P < .05). , , blood lactate, and heart rate increased as a result of exercise (P < .05), with no differences between conditions. Similarly, blood pH, bicarbonate, and base excess decreased as a result of exercise (P < .05), with no difference between conditions. Conclusions: Wearing lower-limb compression tights during RSE with short intervals of rest improved cycling performance, vastus lateralis mBF, and heart rate. These results provide novel data to support the notion that lower-limb compression garments aid RSE performance, which may be related to local and/or central blood flow.
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Flevas DA, Megaloikonomos PD, Dimopoulos L, Mitsiokapa E, Koulouvaris P, Mavrogenis AF. Thromboembolism prophylaxis in orthopaedics: an update. EFORT Open Rev 2018; 3:136-148. [PMID: 29780621 PMCID: PMC5941651 DOI: 10.1302/2058-5241.3.170018] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death. Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%. VTE prophylaxis methods are divided into mechanical and pharmacological. The former include mobilization, graduated compression stockings, intermittent pneumatic compression device and venous foot pumps; the latter include aspirin, unfractionated heparin, low molecular weight heparin (LMWH), adjusted dose vitamin K antagonists, synthetic pentasaccharid factor Xa inhibitor (fondaparinux) and newer oral anticoagulants. LMWH seems to be more efficient overall compared with the other available agents. We remain sceptical about the use of aspirin as a sole method of prophylaxis in total hip and knee replacement and hip fracture surgery, while controversy still exists regarding the use of VTE prophylaxis in knee arthroscopy, lower leg injuries and upper extremity surgery.
Cite this article: EFORT Open Rev 2018;3:136-148. DOI: 10.1302/2058-5241.3.170018
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Affiliation(s)
- Dimitrios A Flevas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panayiotis D Megaloikonomos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Leonidas Dimopoulos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evanthia Mitsiokapa
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panayiotis Koulouvaris
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Sindhu KK, Cohen B, Blood T, Gil JA, Owens B. Upper Extremity Deep Venous Thrombosis Prophylaxis After Elective Upper Extremity Surgery. Orthopedics 2018; 41:21-27. [PMID: 28877326 DOI: 10.3928/01477447-20170824-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/30/2017] [Indexed: 02/03/2023]
Abstract
Historically, upper extremity deep venous thromboses (DVTs) have been rare; however, their incidence has increased as awareness has increased. Patients who develop upper extremity DVTs often have multiple comorbidities. However, in the past decade, studies have found a small risk of upper extremity DVTs associated with orthopedic procedures involving the upper extremity. The risk of complications following a DVT, including postthrombotic syndrome and pulmonary embolism, is substantially higher with a DVT of the upper extremity compared with a DVT of the lower extremity. Furthermore, there is no consensus regarding the role and efficacy of prophylactic measures in preventing upper extremity DVT after upper extremity surgery. This article discusses the use of prophylactic agents after elective upper extremity surgery, with an emphasis on the efficacy of commonly used interventions. [Orthopedics. 2018; 41(1):21-27.].
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Superimposition of elastic and nonelastic compression bandages. J Vasc Surg Venous Lymphat Disord 2017; 5:851-858. [DOI: 10.1016/j.jvsv.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/07/2017] [Indexed: 11/19/2022]
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Ezenwa BN, Kernozek T. Muscle fiber excitation system. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:5233-5236. [PMID: 28269444 DOI: 10.1109/embc.2016.7591907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Persons unable to exercise due to old age, immobility or medical condition may develop low bone density, decline in muscle contraction, blood pooling or clot. Due to musculoskeletal fragility caution is required in bone and muscle strengthening. Similarly, caution is required to use anticoagulant drug to prevent blood clot due to side effect, and compression devices are not as effective as drug. This paper presents a transcutaneous muscle fiber excitation system adaptable for use in seated, walking or lying position. Clinical trials will determine performance in pathological cases.
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Prevention of venous thromboembolism in gynecologic oncology surgery. Gynecol Oncol 2016; 144:420-427. [PMID: 27890280 DOI: 10.1016/j.ygyno.2016.11.036] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/13/2016] [Accepted: 11/21/2016] [Indexed: 01/30/2023]
Abstract
Gynecologic oncology patients are at a high-risk of postoperative venous thromboembolism and these events are a source of major morbidity and mortality. Given the availability of prophylaxis regimens, a structured comprehensive plan for prophylaxis is necessary to care for this population. There are many prophylaxis strategies and pharmacologic agents available to the practicing gynecologic oncologist. Current venous thromboembolism prophylaxis strategies include mechanical prophylaxis, preoperative pharmacologic prophylaxis, postoperative pharmacologic prophylaxis and extended duration pharmacologic prophylaxis that the patient continues at home after hospital discharge. In this review, we will summarize the available pharmacologic prophylaxis agents and discuss currently used prophylaxis strategies. When available, evidence from the gynecologic oncology patient population will be highlighted.
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Dennis M, Sandercock P, Graham C, Forbes J, Smith J. The Clots in Legs Or sTockings after Stroke (CLOTS) 3 trial: a randomised controlled trial to determine whether or not intermittent pneumatic compression reduces the risk of post-stroke deep vein thrombosis and to estimate its cost-effectiveness. Health Technol Assess 2016; 19:1-90. [PMID: 26418530 DOI: 10.3310/hta19760] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is a common cause of death and morbidity in stroke patients. There are few data concerning the effectiveness of intermittent pneumatic compression (IPC) in treating patients with stroke. OBJECTIVES To establish whether or not the application of IPC to the legs of immobile stroke patients reduced their risk of deep vein thrombosis (DVT). DESIGN Clots in Legs Or sTockings after Stroke (CLOTS) 3 was a multicentre, parallel-group, randomised controlled trial which allocated patients via a central randomisation system to IPC or no IPC. A technician blinded to treatment allocation performed compression duplex ultrasound (CDU) of both legs at 7-10 days and 25-30 days after enrolment. We followed up patients for 6 months to determine survival and later symptomatic VTE. Patients were analysed according to their treatment allocation. SETTING We enrolled 2876 patients in 94 UK hospitals between 8 December 2008 and 6 September 2012. PARTICIPANTS INCLUSION CRITERIA patients admitted to hospital within 3 days of acute stroke and who were immobile on the day of admission (day 0) to day 3. EXCLUSION CRITERIA age < 16 years; subarachnoid haemorrhage; and contra-indications to IPC including dermatitis, leg ulcers, severe oedema, severe peripheral vascular disease and congestive cardiac failure. INTERVENTIONS Participants were allocated to routine care or routine care plus IPC for 30 days, or until earlier discharge or walking independently. MAIN OUTCOME MEASURES The primary outcome was DVT in popliteal or femoral veins, detected on a screening CDU, or any symptomatic DVT in the proximal veins, confirmed by imaging, within 30 days of randomisation. The secondary outcomes included death, any DVTs, symptomatic DVTs, pulmonary emboli, skin breaks on the legs, falls with injury or fractures and duration of IPC use occurring within 30 days of randomisation and survival, symptomatic VTE, disability (as measured by the Oxford Handicap Scale), quality of life (as measured by the European Quality of Life-5 Dimensions 3 Level questionnaire) and length of initial hospital stay measured 6 months after randomisation. RESULTS We allocated 1438 patients to IPC and 1438 to no IPC. The primary outcome occurred in 122 (8.5%) of 1438 patients allocated to IPC and 174 (12.1%) of 1438 patients allocated to no IPC, giving an absolute reduction in risk of 3.6% [95% confidence interval (CI) 1.4% to 5.8%] and a relative risk reduction of 0.69 (95% CI 0.55 to 0.86). After excluding 323 patients who died prior to any primary outcome and 41 who had no screening CDU, the primary outcome occurred in 122 of 1267 IPC participants compared with 174 of 1245 no-IPC participants, giving an adjusted odds ratio of 0.65 (95% CI 0.51 to 0.84; p = 0.001). Secondary outcomes in IPC compared with no-IPC participants were death in the treatment period in 156 (10.8%) versus 189 (13.1%) (p = 0.058); skin breaks in 44 (3.1%) versus 20 (1.4%) (p = 0.002); and falls with injury in 33 (2.3%) versus 24 (1.7%) (p = 0.221). Among patients treated with IPC, there was a statistically significant improvement in survival to 6 months (hazard ratio 0.86, 95% CI 0.73 to 0.99; p = 0.042), but no improvement in disability. The direct cost of preventing a DVT was £1282 per event (95% CI £785 to £3077). CONCLUSIONS IPC is an effective and inexpensive method of reducing the risk of DVT and improving survival in immobile stroke patients. FUTURE RESEARCH Further research should test whether or not IPC improves survival in other groups of high-risk hospitalised medical patients. In addition, research into methods to improve adherence to IPC might increase the benefits of IPC in stroke patients. TRIAL REGISTRATION Current Controlled Trials ISRCTN93529999. FUNDING The start-up phase of the trial (December 2008-March 2010) was funded by the Chief Scientist Office of the Scottish Government (reference number CZH/4/417). The main phase of the trial was funded by the National Institute for Health Research Health Technology Assessment programme (reference number 08/14/03). Covidien Ltd (Mansfield, MA, USA) lent its Kendall SCD™ Express sequential compression system controllers to the 105 centres involved in the trial and donated supplies of its sleeves. It also provided logistical help in keeping our centres supplied with sleeves and training materials relevant to the use of their devices. Recruitment and follow-up were supported by the National Institute for Health Research-funded UK Stroke Research Network and by the Scottish Stroke Research Network, which was supported by NHS Research Scotland.
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Affiliation(s)
- Martin Dennis
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Peter Sandercock
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Catriona Graham
- Epidemiology and Statistics Core, Wellcome Trust Clinical Research Facility, University of Edinburgh, Edinburgh, UK
| | - John Forbes
- Health Research Institute, University of Limerick, Limerick, Ireland
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The Effectiveness of a Risk Stratification Protocol for Thromboembolism Prophylaxis After Hip and Knee Arthroplasty. J Arthroplasty 2016; 31:1299-1306. [PMID: 26777547 DOI: 10.1016/j.arth.2015.12.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study's purpose was to present our institution's experience with the use of a risk stratification protocol for venous thromboembolism (VTE) prophylaxis in joint arthroplasty in which "routine" risk patients receive a mobile compression device in conjunction with aspirin and "high"-risk patients receive warfarin for thromboprophylaxis. METHODS This was a prospective study of patients undergoing primary or revision knee or hip arthroplasty. Exclusion criteria were patients with a current deep vein thrombosis, history of pulmonary embolism, chronic warfarin therapy, planned multiple surgeries, and prolonged postoperative immobilization. Patients were stratified as either routine or high risk. Routine risk patients received mobile compression devices for 10 days and aspirin twice daily for 6 weeks, whereas high-risk patients received warfarin for 4 weeks and compression stockings for 6 weeks. RESULTS A total of 3143 total joint arthroplasties were enrolled (2222, 70.7% "routine"; 921, 29.3% "high risk"). The rate of symptomatic VTE within 6 weeks postoperatively was 0.7% (95% CI 0.3%-1.0%) in the standard vs 0.5% (95% CI 0.01%-1.0%) in the high-risk cohort (P = .67), and within 6 months postoperatively was 0.6% (95% CI 0.3%-1.0%) in the standard vs 1.1% (95% CI 0.4%-1.8%) in the high-risk cohort (P = .23). The rate of major bleeding events was significantly lower in the routine (0.4%; 95% CI 0.1%-0.6%) vs high-risk (2.0%; 95% CI 1.0%-3.0%; P < .001) cohort. CONCLUSIONS This study demonstrates that use of a risk stratification protocol allowed the avoidance of more aggressive anticoagulation in 70% of patients while achieving a low overall incidence of symptomatic VTE.
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Wannop JW, Worobets JT, Madden R, Stefanyshyn DJ. Influence of Compression and Stiffness Apparel on Vertical Jump Performance. J Strength Cond Res 2016; 30:1093-101. [PMID: 27003453 DOI: 10.1519/jsc.0000000000001195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Compression apparel alters both compression of the soft tissues and the hip joint stiffness of athletes. It is not known whether it is the compression elements, the stiffness elements, or some combination that increases performance. Therefore, the purpose of this study was to determine how systematically increasing upper leg compression and hip joint stiffness independently from one another affects vertical jumping performance. Ten male athletes performed countermovement vertical jumps in 8 concept apparel conditions and 1 control condition (loose fitting shorts). The 8 apparel conditions, 4 that specifically altered the amount of compression exerted on the thigh and 4 that altered the hip joint stiffness by means of elastic thermoplastic polyurethane bands, were tested on 2 separate testing sessions (one testing the compression apparel and the other testing the stiffness apparel). Maximum jump height was measured, while kinematic data of the hip, knee, and ankle joint were recorded with a high-speed camera (480 Hz). Both compression and stiffness apparel can have a positive influence on vertical jumping performance. The increase in jump height for the optimal compression was due to increased hip joint range of motion and a trend of increasing the jump time. Optimal stiffness also increased jump height and had the trend of decreasing the hip joint range of motion and hip joint angular velocity. The exact mechanisms by which apparel interventions alter performance is not clear, but it may be due to alterations to the force-length and force-velocity relationships of muscle.
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Affiliation(s)
- John W Wannop
- Human Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Chan V, Duffield R, Watsford M. The effects of compression garments on performance of prolonged manual-labour exercise and recovery. Appl Physiol Nutr Metab 2016; 41:125-32. [DOI: 10.1139/apnm-2015-0335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated the effects of wearing compression garments during and 24 h following a 4-h exercise protocol simulating manual-labour tasks. Ten physically trained male participants, familiar with labouring activities, undertook 4 h of work tasks characteristic of industrial workplaces. Participants completed 2 testing sessions, separated by at least 1 week. In the experimental condition, participants wore a full-length compression top and compression shorts during the exercise protocol and overnight recovery, with normal work clothes worn in the control condition. Testing for serum creatine kinase and C-reactive protein, handgrip strength, knee flexion and extension torque, muscle stiffness, perceived muscle soreness and fatigue as well as heart rate and rating of perceived exertion (RPE) responses to 4-min cycling were performed before, following, and 24 h after exercise. Creatine kinase, muscle soreness, and rating of perceived fatigue increased following the exercise protocol (p < 0.05) as did RPE to a standardised cycling warm-up bout. Conversely, no postexercise changes were observed in C-reactive protein, handgrip strength, peak knee flexion torque, or stiffness measures (p > 0.05). Knee extension torque was significantly higher in the control condition at 24 h postexercise (3.1% ± 5.4% change; compression: 2.2% ± 11.1% change), although no other variables were different between conditions at any time. However, compression demonstrated a moderate–large effect (d > 0.60) to reduce perceived muscle soreness, fatigue, and RPE from standardised warm-up at 24 h postexercise. The current findings suggest that compression may assist in perceptual recovery from manual-labour exercise with implications for the ability to perform subsequent work bouts.
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Affiliation(s)
- Val Chan
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
| | - Rob Duffield
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
| | - Mark Watsford
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Lindfield, Australia
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Role of Physical Therapists in the Management of Individuals at Risk for or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline. Phys Ther 2016; 96:143-66. [PMID: 26515263 DOI: 10.2522/ptj.20150264] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/24/2015] [Indexed: 02/09/2023]
Abstract
The American Physical Therapy Association (APTA), in conjunction with the Cardiovascular & Pulmonary and Acute Care sections of APTA, have developed this clinical practice guideline to assist physical therapists in their decision-making process when treating patients at risk for venous thromboembolism (VTE) or diagnosed with a lower extremity deep vein thrombosis (LE DVT). No matter the practice setting, physical therapists work with patients who are at risk for or have a history of VTE. This document will guide physical therapist practice in the prevention of, screening for, and treatment of patients at risk for or diagnosed with LE DVT. Through a systematic review of published studies and a structured appraisal process, key action statements were written to guide the physical therapist. The evidence supporting each action was rated, and the strength of statement was determined. Clinical practice algorithms, based on the key action statements, were developed that can assist with clinical decision making. Physical therapists, along with other members of the health care team, should work to implement these key action statements to decrease the incidence of VTE, improve the diagnosis and acute management of LE DVT, and reduce the long-term complications of LE DVT.
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Muñoz-Figueroa GP, Ojo O. Venous thromboembolism: use of graduated compression stockings. ACTA ACUST UNITED AC 2015; 24:680, 682-5. [DOI: 10.12968/bjon.2015.24.13.680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Omorogieva Ojo
- Senior Lecturer in Primary Care, Faculty of Education and Health, University of Greenwich, London
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Priego Quesada JI, Lucas-Cuevas AG, Gil-Calvo M, Giménez JV, Aparicio I, Cibrián Ortiz de Anda RM, Salvador Palmer R, Llana-Belloch S, Pérez-Soriano P. Effects of graduated compression stockings on skin temperature after running. J Therm Biol 2015; 52:130-6. [PMID: 26267507 DOI: 10.1016/j.jtherbio.2015.06.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/19/2022]
Abstract
High skin temperatures reduce the thermal gradient between the core and the skin and they can lead to a reduction in performance and increased risk of injury. Graduated compression stockings have become popular among runners in the last years and their use may influence the athlete's thermoregulation. The aim of this study was to investigate the effects of graduated compression stockings on skin temperature during running in a moderate indoor environment. Forty-four runners performed two running tests lasting 30min (10min of warm-up and 20min at 75% of their maximal aerobic speed) with and without graduated compressive stockings. Skin temperature was measured in 12 regions of interest on the lower limb by infrared thermography before and after running. Heart rate and perception of fatigue were assessed during the last minute of the running test. Compression stockings resulted in greater increase of temperature (p=0.002 and ES=2.2, 95% CI [0.11-0.45°C]) not only in the body regions in contact (tibialis anterior, ankle anterior and gastrocnemius) but also in the body regions that were not in contact with the garment (vastus lateralis, abductor and semitendinosus). No differences were observed between conditions in heart rate and perception of fatigue (p>0.05 and ES<0.8). In conclusion, running with graduated compression stockings produces a greater increase of skin temperature without modifying the athlete's heart rate and perception of fatigue.
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Affiliation(s)
- J I Priego Quesada
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain; Biophysics and Medical Physics Group, Department of Physiology, University of Valencia, Valencia, Spain.
| | - A G Lucas-Cuevas
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - M Gil-Calvo
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - J V Giménez
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - I Aparicio
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - R M Cibrián Ortiz de Anda
- Biophysics and Medical Physics Group, Department of Physiology, University of Valencia, Valencia, Spain
| | - R Salvador Palmer
- Biophysics and Medical Physics Group, Department of Physiology, University of Valencia, Valencia, Spain
| | - S Llana-Belloch
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - P Pérez-Soriano
- Research Group in Sport Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
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Chassagne F, Martin F, Badel P, Convert R, Giraux P, Molimard J. Experimental Investigation of Pressure Applied on the Lower Leg by Elastic Compression Bandage. Ann Biomed Eng 2015; 43:2967-77. [DOI: 10.1007/s10439-015-1352-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/29/2015] [Indexed: 11/30/2022]
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Reduction in the soles of graduated compression stockings prevents falls without reducing the preventive effect for venous stasis. Thromb Res 2015; 135:877-81. [DOI: 10.1016/j.thromres.2015.02.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/22/2015] [Accepted: 02/20/2015] [Indexed: 11/21/2022]
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Priego JI, Lucas-Cuevas AG, Aparicio I, Giménez JV, Cortell-Tormo JM, Pérez-Soriano P. Long-term effects of graduated compression stockings on cardiorespiratory performance. Biol Sport 2015; 32:219-23. [PMID: 26424925 PMCID: PMC4577560 DOI: 10.5604/20831862.1150304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 12/07/2014] [Accepted: 12/22/2014] [Indexed: 11/13/2022] Open
Abstract
The use of graduated compression stockings (GCS) in sport has been increasing in the last years due to their potential positive effects for athletes. However, there is little evidence to support whether these types of garments actually improve cardiorespiratory performance. The aim of this study was to examine the cardiorespiratory responses of GCS during running after three weeks of regular use. Twenty recreational runners performed three tests on different days: test 1) - a 5-min maximal effort run in order to determine the participants' maximal aerobic speed; and tests 2) and 3) - a fatigue running test of 30 minutes at 80% of their maximal aerobic speed with either GCS or PLACEBO stockings at random. Cardiorespiratory parameters (minute ventilation, heart rate, relative oxygen consumption, relative carbon dioxide production, ventilatory equivalents for oxygen and carbon dioxide, and oxygen pulse) were measured. Before each test in the laboratory, the participants trained with the randomly assigned stockings (GCS or PLACEBO) for three weeks. No significant differences between GCS and PLACEBO were found in any of the cardiorespiratory parameters. In conclusion, the present study provides evidence that running with GCS for three weeks does not influence cardiorespiratory parameters in recreational runners.
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Affiliation(s)
- J I Priego
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain ; Department of Physiology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - A G Lucas-Cuevas
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - I Aparicio
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - J V Giménez
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - J M Cortell-Tormo
- Department of General and Specific Didactics, Faculty of Education, University of Alicante, San Vicente del Raspeig - Alicante, Spain
| | - P Pérez-Soriano
- Research Group in Sports Biomechanics (GIBD), Department of Physical Education and Sports, University of Valencia, Valencia, Spain
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Yilmaz S, Calbiyik M, Yilmaz BK, Aksoy E. Potential role of electrostimulation in augmentation of venous blood flow after total knee replacement: A pilot study. Phlebology 2015; 31:251-6. [DOI: 10.1177/0268355515580473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim To investigate the potential role of a novel electrostimulation device in augmenting the femoral vein venous blood flow following total knee replacement surgery. Material and methods A total of 30 consecutive patients undergoing total knee replacement were allocated to receive either peroneal nerve electrostimulation plus low molecular weight heparin and below-knee compression stockings (Group 1, electrostimulation group, n = 15, mean age: 63.40 ± 5.91 years, male: female ratio 9:6) or low molecular weight heparin and below-knee compression stockings alone (Group 2, control group, n = 15, mean age: 63.86 ± 7.47 years, male: female ratio 8:7). Electrostimulation was performed for 1 h in every 4 h after the operation. Peak blood velocity in the femoral vein was evaluated with Duplex ultrasonongraphy in supine position. Presence of leg edema and calf diameter was also taken into consideration as outcome measures, which were recorded both before surgery and at the time of discharge from hospital. Results Postoperative peak blood flow velocity in the femoral vein was significantly higher in electrostimulation group compared to control group (17.46 ± 2.86 cm/s vs. 13.84 ± 3.58 cm/s, p < 0.02). Electrostimulation group achieved a significant increase in peak blood flow velocity in the femoral vein after the operation (mean increase 67.48 ± 17.38%, p < 0.001). Conclusion Electrostimulation of the common peroneal nerve enhanced venous flow in the lower limb and may potentially be of use as a supplementary technique in deep venous prophylaxis following lower limb orthopedic operations.
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Affiliation(s)
- Seyhan Yilmaz
- Department of Cardiovascular Surgery, Hitit University Corum Education and Research Hospital, Turkey
| | - Murat Calbiyik
- Department of Orthopaedics, Hitit University Corum Education and Research Hospital, Turkey
| | - Behice Kaniye Yilmaz
- Department of Radiology, Hitit University Corum Education and Research Hospital, Turkey
| | - Eray Aksoy
- Department of Cardiovascular Surgery, Hitit University Corum Education and Research Hospital, Turkey
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Prediction of the Biomechanical Effects of Compression Therapy on Deep Veins Using Finite Element Modelling. Ann Biomed Eng 2014; 43:314-24. [PMID: 25224080 DOI: 10.1007/s10439-014-1121-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022]
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Abstract
Venous thromboembolism (VTE) can occur after major general surgery. Pulmonary embolism is recognized as the most common identifiable cause of death in hospitalized patients in the United States. The risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) is higher in colorectal surgical procedures compared with general surgical procedures. The incidence of venous thromboembolism in this population is estimated to be 0.2 to 0.3%. Prevention of VTE is considered a patient-safety measure in most mandated quality initiatives. The measures for prevention of VTE include mechanical methods (graduated compression stockings and intermittent pneumatic compression devices) and pharmacologic agents. A combination of mechanical and pharmacologic methods produces the best results. Patients undergoing surgery should be stratified according to their risk of VTE based on patient risk factors, disease-related risk factors, and procedure-related risk factors. The type of prophylaxis should be commensurate with the risk of VTE based on the composite risk profile.
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Affiliation(s)
- Jonathan Laryea
- Division of Colon and Rectal Surgery, Department of surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Bradley Champagne
- Division of Colon and Rectal Surgery, Department of surgery, Case Western Reserve University, Cleveland, Ohio
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Born DP, Holmberg HC, Goernert F, Sperlich B. A novel compression garment with adhesive silicone stripes improves repeated sprint performance - a multi-experimental approach on the underlying mechanisms. BMC Sports Sci Med Rehabil 2014; 6:21. [PMID: 24914412 PMCID: PMC4049427 DOI: 10.1186/2052-1847-6-21] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 05/06/2014] [Indexed: 12/02/2022]
Abstract
Background Repeated sprint performance is determined by explosive production of power, as well as rapid recovery between successive sprints, and there is evidence that compression garments and sports taping can improve both of these factors. Methods In each of two sub-studies, female athletes performed two sets of 30 30-m sprints (one sprint per minute), one set wearing compression garment with adhesive silicone stripes (CGSS) intended to mimic taping and the other with normal clothing, in randomized order. Sub-study 1 (n = 12) focused on cardio-respiratory, metabolic, hemodynamic and perceptual responses, while neuronal and biomechanical parameters were examined in sub-study 2 (n = 12). Results In both sub-studies the CGSS improved repeated sprint performance during the final 10 sprints (best P < 0.01, d = 0.61). None of the cardio-respiratory or metabolic variables monitored were altered by wearing this garment (best P = 0.06, d = 0.71). Also during the final 10 sprints, rating of perceived exertion by the upper leg muscles was reduced (P = 0.01, d = 1.1), step length increased (P = 0.01, d = 0.91) and activation of the m. rectus femoris elevated (P = 0.01, d = 1.24), while the hip flexion angle was lowered throughout the protocol (best P < 0.01, d = 2.28) and step frequency (best P = 0.34, d = 0.2) remained unaltered. Conclusion Although the physiological parameters monitored were unchanged, the CGSS appears to improve performance during 30 30-m repeated sprints by reducing perceived exertion and altering running technique.
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Affiliation(s)
- Dennis-Peter Born
- Department of Sport Science, University of Wuppertal, Fuhlrottstraße 10, 42119 Wuppertal, Germany ; Department of Sport Sciences, Integrative and Experimental Exercise Science, University of Würzburg, 97082 Würzburg, Germany
| | - Hans-Christer Holmberg
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, 83125 Östersund, Sweden
| | - Florian Goernert
- Department of Sport Science, University of Wuppertal, Fuhlrottstraße 10, 42119 Wuppertal, Germany
| | - Billy Sperlich
- Department of Sport Science, University of Wuppertal, Fuhlrottstraße 10, 42119 Wuppertal, Germany ; Department of Sport Sciences, Integrative and Experimental Exercise Science, University of Würzburg, 97082 Würzburg, Germany
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Venous thromboembolism prophylactic methods in acute stroke patients - current state of knowledge. Neurol Neurochir Pol 2014; 47:564-71. [PMID: 24375002 DOI: 10.5114/ninp.2013.39074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Deep venous thrombosis (DVT) and its sequel, pulmo-nary em-bolism (PE), are serious complications of stroke. There are pharmacological and physical methods to prevent these complications. The authors review the lite-rature and present the current state of knowledge re-garding the effectiveness of each of the DVT and PE prevention methods in stroke patients and cite current Polish, European and American recommendations re-garding this issue. Heparins are the method of choice for the prevention of venous thromboembolism in both ischaemic and haemorrhagic stroke patients.
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[Physical prophylaxis for thromboembolism. Current state of knowledge on use of medical thromboprophylaxis stockings]. Chirurg 2013; 84:1057-61. [PMID: 24068203 DOI: 10.1007/s00104-013-2626-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Thromboprophylaxis in surgery patients is a combination of physical and medical thromboprophylaxis. The established mode of physical thromboprophylaxis in Germany is graduated compression stockings. Recent publications from various authors generally scrutinized the additional benefits of physical prophylaxis in patients who received medical thromboprophylaxis. MATERIAL AND METHODS A thorough search was carried out in PubMed and Medline. The focus of the search was on studies which investigated the advantages of physical thromboprophylaxis in surgery patients. RESULTS The low amount of evidence available for prophylaxis of thromboembolism in surgery patients was mainly deduced from trials that had a combination of medical and physical thromboprophylaxis as part of the study protocol. The results of experimental investigations were able to show a statistically highly significant reduction of the diameter of lower extremity veins. CONCLUSION There is no current evidence to support refraining from routine use of graduated compression stockings in surgery patients. This is also the case for the new oral anti-Xa and anti-IIa inhibitors.
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Abstract
Venous thromboembolism (VTE) can occur after major general surgery. Pulmonary embolism is recognized as the most common identifiable cause of death in hospitalized patients in the United States. The risk of deep venous thrombosis (DVT) and pulmonary embolism (PE) is higher in colorectal surgical procedures compared with general surgical procedures. The incidence of venous thromboembolism in this population is estimated to be 0.2 to 0.3%. Prevention of VTE is considered a patient-safety measure in most mandated quality initiatives. The measures for prevention of VTE include mechanical methods (graduated compression stockings and intermittent pneumatic compression devices) and pharmacologic agents. A combination of mechanical and pharmacologic methods produces the best results. Patients undergoing surgery should be stratified according to their risk of VTE based on patient risk factors, disease-related risk factors, and procedure-related risk factors. The type of prophylaxis should be commensurate with the risk of VTE based on the composite risk profile.
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Affiliation(s)
- Jonathan Laryea
- Division of Colon and Rectal Surgery, Department of surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Bradley Champagne
- Division of Colon and Rectal Surgery, Department of surgery, Case Western Reserve University, Cleveland, Ohio
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Biomechanische Charakterisierung von medizinischen Thromboseprophylaxestrümpfen (MTPS). GEFÄSSCHIRURGIE 2013. [DOI: 10.1007/s00772-013-1180-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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The Effects of Wearing Lower Body Compression Garments During a Cycling Performance Test. Int J Sports Physiol Perform 2013; 8:300-6. [DOI: 10.1123/ijspp.8.3.300] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose:Compression garments have been commonly used in a medical setting as a method to promote blood flow. Increases in blood flow during exercise may aid in the delivery of oxygen to the exercising muscles and, subsequently, enhance performance. The aim of the current study was to investigate the effect of wearing lower body compression garments during a cycling test.Methods:Twelve highly trained cyclists (mean ± SD age 30 ± 6 y, mass 75.6 ± 5.8 kg, VO2peak 66.6 ± 3.4 mL · kg−1 · min−1) performed two 30-min cycling bouts on a cycle ergometer in a randomized, crossover design. During exercise, either full-length lower body compression garments (COMP) or above-knee cycling shorts (CON) were worn. Cycling bouts involved 15 min at a fixed workload (70% of VO2max power) followed by a 15-min time trial. Heart rate (HR) and blood lactate (BL) were measured during the fixed-intensity component of the cycling bout to determine the physiological effect of the garments. Calf girth (CG), thigh girth (TG) and perceived soreness (PS) were measured preexercise and postexercise.Results:COMP produced a trivial effect on mean power output (ES = .14) compared with CON (mean ± 95% CI 1.3 ±1.0). COMP was also associated with a lower HR during the fixed-workload section of the test (−2.6% ± 2.3%, ES = −.38). There were no differences between groups for BL, CG, TG, and PS.Conclusion:Wearing compression garments during cycling may result in trivial performance improvements of ~1% and may enhance oxygen delivery to the exercising muscles.
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Sperlich B, Born DP, Kaskinoro K, Kalliokoski KK, Laaksonen MS. Squeezing the muscle: compression clothing and muscle metabolism during recovery from high intensity exercise. PLoS One 2013; 8:e60923. [PMID: 23613756 PMCID: PMC3629206 DOI: 10.1371/journal.pone.0060923] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 03/04/2013] [Indexed: 11/18/2022] Open
Abstract
The purpose of this experiment was to investigate skeletal muscle blood flow and glucose uptake in m. biceps (BF) and m. quadriceps femoris (QF) 1) during recovery from high intensity cycle exercise, and 2) while wearing a compression short applying ∼37 mmHg to the thigh muscles. Blood flow and glucose uptake were measured in the compressed and non-compressed leg of 6 healthy men by using positron emission tomography. At baseline blood flow in QF (P = 0.79) and BF (P = 0.90) did not differ between the compressed and the non-compressed leg. During recovery muscle blood flow was higher compared to baseline in both compressed (P<0.01) and non-compressed QF (P<0.001) but not in compressed (P = 0.41) and non-compressed BF (P = 0.05; effect size = 2.74). During recovery blood flow was lower in compressed QF (P<0.01) but not in BF (P = 0.26) compared to the non-compressed muscles. During baseline and recovery no differences in blood flow were detected between the superficial and deep parts of QF in both, compressed (baseline P = 0.79; recovery P = 0.68) and non-compressed leg (baseline P = 0.64; recovery P = 0.06). During recovery glucose uptake was higher in QF compared to BF in both conditions (P<0.01) with no difference between the compressed and non-compressed thigh. Glucose uptake was higher in the deep compared to the superficial parts of QF (compression leg P = 0.02). These results demonstrate that wearing compression shorts with ∼37 mmHg of external pressure reduces blood flow both in the deep and superficial regions of muscle tissue during recovery from high intensity exercise but does not affect glucose uptake in BF and QF.
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Affiliation(s)
- Billy Sperlich
- Department of Sport Science, University of Wuppertal, Wuppertal, Germany.
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