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Poschinger-Figueiredo D, Virgini-Magalhães CE, Amorim CS, Poschinger AKP, Chequer FP. Impact of Ultrasound-Guided Foam Sclerotherapy for Pain Control in Patients with Chronic Venous Disease and Great Saphenous Vein Reflux. Int J Angiol 2023; 32:172-178. [PMID: 37576530 PMCID: PMC10421696 DOI: 10.1055/s-0042-1758384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chronic venous disease (CVD) associated with great saphenous vein (GSV) reflux has a higher prevalence of pain in the lower limbs. This study evaluates the impact of ultrasound-guided foam sclerotherapy (UGFS) for GSV and symptom control, accessed by the visual analogue scale (VAS). Patients with CVD who underwent GSV-UGFS were included in this retrospective cohort (417 limbs). The pain was measured before and after the treatment. The scale alteration was assessed as a function of age, sex, Clinical Etiologic Anatomic Pathophysiologic (CEAP) classes, total of sclerotherapy sessions, GSV occlusion patterns, and ulcer healing. Majority of patients were female (59.2%), and the mean age was 56 ± 11.5 years. In the total sample, 78.2% of the GSVs were fully occluded, 19.7% had partial occlusion, 2.2% remained open, and 3.2 ± 1.9 (median = 3.0) sessions were performed. The reduction of symptoms occurred in 88.3% of participants (VAS drop median = 4.8). Patients younger than 50 years and females had the greatest VAS decreases. When comparing the outcomes of complete occlusion versus partial occlusion, there was no significant difference in VAS pain reduction ( p = 0.14). The comparison between CEAP clinical classes also did not show statistically significant differences in delta VAS ( p = 0.71). GSV-UGFS was effective for pain control. However, this improvement does not appear to be related to the pattern of occlusion, indicating that in the short term, the outcomes of total and partial occlusion suggest successful management of symptoms. Other aspects such as gender, age, pretreatment pain intensity, and CEAP classes seem to play a role in the clinical outcome.
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Affiliation(s)
- Douglas Poschinger-Figueiredo
- Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Carlos Eduardo Virgini-Magalhães
- Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Claudia Salvador Amorim
- Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Alessandra Krykhtine Peres Poschinger
- Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - Fernanda Pires Chequer
- Teaching and Health Care Unit of Vascular and Endovascular Surgery (CT Vascular), Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
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Yu M, Ye F, Ma C, Jin X, Ji H, Wang D, Yang Y, Zhu C, Tang Z. Ligustrazine mitigates chronic venous disease-induced pain hyperalgesia through desensitization of inflammation-associated TRPA1 activity in DRG. JOURNAL OF ETHNOPHARMACOLOGY 2022; 298:115667. [PMID: 36030028 DOI: 10.1016/j.jep.2022.115667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/09/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ligustrazine, an important active ingredient extracted from Ligusticum chuanxiong hort, has been widely used to cure cardiovascular diseases and exerts an analgesic effect. AIMS OF THIS STUDY The aim of this study is to investigate whether ligustrazine mitigates chronic venous disease (CVeD)-induced pain and to explore its underlying mechanisms. MATERIALS AND METHODS A mouse model of CVeD was established by vein ligature. Ligustrazine was administered intraperitoneally to CVeD mice for a single injection (20 mg/kg, 100 mg/kg, and 200 mg/kg) or once a day for three weeks (100 mg/kg and 200 mg/kg), and TRPA1 overexpressed HEK 293 cells were treated with ligustrazine (600 μM) in the presence of mustard oil (100 μM) for 2 min. Patch clamp and calcium imaging were used to measure the inhibitory response of ligustrazine on DRG neurons and TRPA1 transfected HEK293 cells. RESULTS The present results showed that mice receiving vein ligature surgery exhibited obvious pain hypersensitivity to mechanical, cold and thermal stimuli, whereas ligustrazine significantly reversed the pain hyperalgesia in CVeD mice. Furthermore, ligustrazine desensitized transient receptor potential ankyrin 1 (TRPA1) activity in the dorsal root ganglion (DRG) neurons, resulting in suppressing the DRG neuronal excitability in the CVeD mice. However, ligustrazine could not directly inhibit the response of TRPA1 transfected HEK293 cells to mustard oil. Strikingly, ligustrazine restricted the macrophage infiltration and decreased the mRNA levels of Interleukin-1β (IL-1β) and NOD-like receptor protein 3 (NLRP3) in the DRG neurons of the CVeD mice. CONCLUSIONS The present study provided evidence that ligustrazine alleviated pain hypersensitivity to mechanical, cold and thermal stimuli in CVeD mice. Ligustrazine could weaken the activity of TRPA1 in the DRG to mitigate CVeD-induced pain hyperalgesia mainly through inhibition of inflammation. Our findings identify that ligustrazine may be a new therapeutic agent for the treatment of CVeD-induced pain.
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Affiliation(s)
- Mei Yu
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China; Department of Pharmacy, Taizhou Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Taizhou, Jiangsu, 225300, China
| | - Fan Ye
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Chao Ma
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Xiang Jin
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Haiwang Ji
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Dijun Wang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Yan Yang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Chan Zhu
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China
| | - Zongxiang Tang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210023, China.
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Kiloatar H, Aras O, Korkmaz M, Vural AH. An evaluation of quality of life, physical activity level and symptoms in patients with early stages of chronic venous disease. JOURNAL OF VASCULAR NURSING 2021; 39:108-113. [PMID: 34865720 DOI: 10.1016/j.jvn.2021.07.007] [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] [Received: 03/05/2021] [Revised: 07/07/2021] [Accepted: 07/28/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Chronic venous disease (CVD) is a common, long-term disease that has a variety of symptoms, signs and decreases the patients' quality of life (QoL) of the patients. The aim of this study was to evaluate QoL, symptoms, and physical activity level of CVD patients with early stages (C1 and C2 classes). METHODS The sample of this study composed of 40 patients diagnosed with CVD. The data were collected by face-to-face interview method in the cardiovascular surgery outpatient clinic. Participants were diagnosed with duplex ultrasound (DUS). A personal information form, venous insufficiency epidemiological and economic study-quality of life/symptoms (VEINS-QOL/Sym), and international physical activity questionnaire were used to assess the participants. RESULTS According to DUS results, 23 participants had unilateral CVD, 17 participants had bilateral CVD. Thirty-six of these limbs were stage C2 according to CEAP, twenty one were stage C3. The patients with CVD had low QoL and physical activity level, also moderate pain intensity. Pain, swelling, restless leg, heavy legs, night cramps, and itching were more common symptoms. There was no statistical difference between unilateral/bilateral CVD patients in QoL scores, physical activity level, and pain intensity (p˃0.05). CONCLUSION There was no difference between the extent and severity of the disease and QoL, physical activity level, variety of symptoms. To increase the physical activity level and to evaluate the quality of life may be important for the management of the disease from the early stages of the disease (C1 and C2 classes).
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Affiliation(s)
- Humeyra Kiloatar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Kutahya Health Sciences University, Campus of Evliya Celebi, 43100 Kutahya, Turkey.
| | - Ozgen Aras
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Kutahya Health Sciences University, Campus of Evliya Celebi, 43100 Kutahya, Turkey
| | - Mehmet Korkmaz
- Department of Radiology, Faculty of Medicine, Kutahya Health Sciences University, Campus of Evliya Celebi, 43100 Kutahya, Turkey
| | - Ahmet Hakan Vural
- Department of Cardiovasculary Surgery, Gebze Medical Park Hospital, Kocaeli, Turkey
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Silva WT, Ávila MR, de Oliveira LFF, de Souza IN, de Almeida ILGI, Madureira FP, Lacerda ACR, Mendonça VA, Pereira DAG, Lima VP, Figueiredo PHS, Costa HS. Differences in health-related quality of life in patients with mild and severe chronic venous insufficiency: A systematic review and meta-analysis. JOURNAL OF VASCULAR NURSING 2021; 39:126-133. [PMID: 34865723 DOI: 10.1016/j.jvn.2021.09.002] [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: 03/22/2021] [Revised: 07/18/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Chronic venous insufficiency (CVI) has a broad spectrum of clinical expression, ranging from mild to severe cases, which negatively impacts the health-related quality of life (HRQoL). However, the comparison in HRQoL between mild and severe CVI has not yet been systematically discussed, which could assist in the adoption of preventive strategies METHODS: A systematic review and meta-analysis was conducted (protocol register https://osf.io/mr4aj/) following a search of the MEDLINE, CINAHL, Web of Science, LILACS, and Scopus databases, using the terms related to CVI and HRQoL. Observational studies that assessed the HRQoL in individuals with CVI in different degrees of severity were included, without date restriction RESULTS: We retrieved 4750 titles and abstracts and 9 were included in this review. The HRQoL was worse in patients with severe CVI compared to mild patients at Short-form of Health Survey (SF-36) (mean difference 11.02, 95% CI from 8.62 to 13.43; p<0.001), Chronic Venous Insufficiency Quality Of Life Questionnaire (CIVIQ-14) (mean difference 13.07; 95% CI from 11.33 to 14.82; p<0.001) and Aberdeen Varicose Veins Questionnaire (mean difference 7.7; 95% CI: -12.82 to -2.58; p=0.003), especially in the physical domains. There was no difference in the HRQoL between severe and mild patients at CIVIQ-20 (p=0.09) CONCLUSION: The HRQoL was worse in the physical domains in patients with severe CVI when compared to mild patients. However, the heterogeneity of the results was high and the data should be interpreted with caution.
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Affiliation(s)
- Whesley Tanor Silva
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Matheus Ribeiro Ávila
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Iara Nepomuceno de Souza
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Igor Lucas Geraldo Izalino de Almeida
- Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | | | - Ana Cristina Rodrigues Lacerda
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Vanessa Amaral Mendonça
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Danielle Aparecida Gomes Pereira
- Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vanessa Pereira Lima
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Henrique Silveira Costa
- Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil; Programa de Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
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Mitchell A, Elbourne S. Lower limb assessment. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:18-21. [PMID: 31917948 DOI: 10.12968/bjon.2020.29.1.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Aby Mitchell
- Senior Lecturer, Adult Nursing, University of West London
| | - Scott Elbourne
- Lecturer, Nursing Associates and Adult Nursing, University of West London
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Ozberk S, Karadibak D, Polat M. Predictors of exercise capacity in chronic venous disease patients. Phlebology 2019; 35:190-198. [DOI: 10.1177/0268355519870895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objectives The aim of this study was to determine predictors of exercise capacity and explore the relationship between exercise capacity, lower extremity performance level, pain, fatigue, physical activity, sleep quality, and quality of life in patients with chronic venous disease. Methods A total of 170 chronic venous disease patients who were referred to the Cardiovascular Surgery department were included. Assessment tools included the six-minute walk test for exercise capacity, repeated sit-to-stand test for lower limb performance level, Visual Analog Scale for pain, Fatigue Severity Scale for fatigue, Pittsburgh Sleep Quality Index for sleep quality, International Physical Activity Questionnaire for physical activity, and Venous Insufficiency Epidemiological and Economic Study’s Quality of Life questionnaire for quality of life. Results Exercise capacity was weakly and negatively correlated with body mass index (r = –0.391, p < 0.001), pain level (r = –0.268, p < 0.001), age (r = –0.355, p < 0.001), and fatigue severity (r = –0.141, p < 0.05). There was a weak positive correlation in walking distance with quality of life (r = –0.129, p < 0.05) and education level (r = 0.166, p < 0.05), whereas moderate positive correlation was observed between walking distance and lower limb performance level (r = 0.518, p < 0.001). Lower limb performance level was a significant predictor of exercise capacity, accounting for 50% of the variance. Conclusions Exercise capacity is an important determinant of morbidity. Therefore, there is a need to improve lower extremity performance and functional mobility in patients suffering from chronic venous disease.
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Affiliation(s)
- Sema Ozberk
- Institute of Health Science, Dokuz Eylul University, Izmir, Turkey
| | - Didem Karadibak
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
| | - Muslum Polat
- Department of Cardiovasculary Surgery, Dr. Ersin Arslan Education and Research Hospital, Gaziantep, Turkey
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Kelechi TJ, Dooley MJ, Mueller M, Madisetti M, Prentice MA. Symptoms Associated With Chronic Venous Disease in Response to a Cooling Treatment Compared to Placebo: A Randomized Clinical Trial. J Wound Ostomy Continence Nurs 2019; 45:301-309. [PMID: 29846278 PMCID: PMC6041185 DOI: 10.1097/won.0000000000000441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to examine the efficacy of a self-administered cooling treatment on clinically meaningful differences (CMDs) in symptom changes in patients with chronic venous disease. DESIGN Blinded, prospective, randomized controlled trial. SUBJECTS AND SETTING Two hundred seventy-six community-dwelling adults 21 years and older with skin changes and/or a healed venous leg ulcer (Clinical-Etiologic-Anatomic-Pathologic [CEAP] 4 and 5 classification) completed the 6-month active treatment period. METHODS Participants were recruited from wound and medicine clinics and from the general population through referrals or advertisements. Participants were randomly allocated to a sham control cuff or interventional cooling cuff group. Demographic and symptom-specific data were collected at baseline and at months 1, 3, and 6 with the 11-item symptom Venous Insufficiency Epidemiological and Economic Study Quality of Life/Symptom (VEINES QOL/Sym) questionnaire subscale for heavy legs, aching legs, swelling, night cramps, heating or burning sensation, restless legs, throbbing, itching, tingling sensation (pins and needles), pain, and irritability. Participants in the intervention group received a cooling gel cuff and those in the control group received a cotton-filled cuff to be place around the most affected lower leg during leg elevation. Both groups received standard of care for their chronic venous disease with compression wraps and skin hygiene. Dosing consisted of daily 30-minute treatment for 1 month, twice weekly for 2 months, and then thrice weekly for 3 months. To analyze and compare data, a mixed percentage clinically meaningful percentage change was used to assess CMDs in symptoms between groups for treatment modality, sex, and age group. RESULTS All symptoms showed improvement, with throbbing, aching, itching, and pain demonstrating the greatest CMD in response to the cooling treatment. For throbbing and aching, similar improvements were noted in response to cooling; 50% in the cooling group showed improvement, whereas 60% in both groups responded favorably to pain. More than 50% of females and males reported improvements in throbbing; both males and females reported 60% improvements in pain in response to cooling. In contrast, far fewer females reported worsening of aching in the treatment group as compared to male participants (8% vs 20%). Age differences were noted for throbbing in the younger group (<65 years of age); older individuals 65 years or older saw CMDs in aching in response to cooling. CONCLUSIONS Of the 11 symptoms, aching, throbbing, itching, and pain had greater clinically meaningful improvements in response to a cooling cuff applied to lower leg skin affected by chronic venous disease. These CMDs inform evidence-based practice by enhancing clinician understanding of which symptoms, physical, physiological, and behavioral outcomes, respond to treatment change in a meaningful way for the patient.
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Affiliation(s)
- Teresa J Kelechi
- Teresa J. Kelechi, PhD, RN, College of Nursing, Medical University of South Carolina, Charleston. Mary J. Dooley, MS, College of Nursing, Medical University of South Carolina, Charleston. Martina Mueller, PhD, College of Nursing, Medical University of South Carolina, Charleston. Mohan Madisetti, MS, College of Nursing, Medical University of South Carolina, Charleston. Margie A. Prentice, MBA, College of Nursing, Medical University of South Carolina, Charleston
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Kelechi TJ, Mueller M, Madisetti M, Prentice MA, Dooley MJ. Effectiveness of cooling therapy (cryotherapy) on leg pain and self-efficacy in patients with chronic venous disease: A randomized controlled trial. Int J Nurs Stud 2018; 86:1-10. [PMID: 29957362 PMCID: PMC6186183 DOI: 10.1016/j.ijnurstu.2018.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Individuals with chronic venous disease (CVeD) frequently experience associated leg pain that may influence disease management self-efficacy. OBJECTIVE To evaluate the influence of a cooling intervention on leg pain associated with more severe stages of CVeD and self-efficacy. This was a secondary aim of the trial. DESIGN Randomized, blinded, comparator-controlled, multisite trial. SETTING Three wound clinics and an academic medical research center in the United States of America. PARTICIPANTS 276 participants (54.3% female, 46.7% male) with stage 4 and 5 CVeD were randomly assigned by computer generated tables to the cooling intervention group (n = 138) or control group (n = 138). INTERVENTIONS Participants received either a cooling (intervention) leg cuff or placebo cuff (control) to apply topically over the affected skin area. Both groups performed standard of care including wearing compression wraps and elevating legs for 30 min during the intervention. Study visits occurred at baseline, and months 1, 3, 6, and 9. METHODS Visit measures included: Numeric Rating Scale (NRS) for short term pain; VEINES-QOL/Sym questionnaire for long-term pain; and, the Self Efficacy for Managing Chronic Disease Scale (SEMCD-6) for self-efficacy. Data were collected from September 2010 to December 2015 and analyzed using pooled t-tests, Chi-square tests, and mixed effects models. Observed 9-month patient retention rates were 94/138 (68.1%) in the intervention group and 91/138 (65.9%) in the control group. The primary analysis was based on the intention-to-treat principle. RESULTS Both the cooling intervention and control group experienced statistically significant decreases in unadjusted and adjusted mean NRS pain scores of 1.2 (95% CI: (-1.82, -0.64); p < 0.0001) and 1.8 (95% CI: (-2.31, -1.24); p < 0.0001) respectively from baseline, however, no statistically significant differences in change scores were observed between groups. The unadjusted mean VEINES-QOL/Sym pain scores had statistically significant decreases of 0.9 ((95% CI: (-1.07, -0.62) p < 0.0001 cooling)) and 0.8 (95% CI: (-1.09, -0.55) p < 0.0001 - control) points. When adjusting the scores for demographic and clinical features, both cooling and control groups maintained statistically significant decreases (p < 0.001 for both). No statistically significant differences in change scores were observed between groups. The unadjusted and adjusted mean self-efficacy scores had no statistically significant improvements from baseline to month 9 within and between the cooling and control groups. CONCLUSIONS Pain was reduced in both groups while self-efficacy did not change. Findings suggest that strictly implemented standard of CVeD care in each study group, with or without cooling, improved pain while there were no effects on self-efficacy.
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Affiliation(s)
- Teresa J Kelechi
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA.
| | - Martina Mueller
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA
| | - Mohan Madisetti
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA
| | - Margie A Prentice
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA
| | - Mary J Dooley
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA
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Radak D, Atanasijević I, Nešković M, Isenovic E. The Significance of Pain in Chronic Venous Disease and its Medical Treatment. Curr Vasc Pharmacol 2018; 17:291-297. [PMID: 29424318 DOI: 10.2174/1570161116666180209111826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 01/23/2018] [Accepted: 01/23/2018] [Indexed: 11/22/2022]
Abstract
Chronic venous disease (CVeD) is a highly prevalent condition in the general population, and it has a significant impact on quality of life. While it is usually manifested by obvious signs, such as varicose veins and venous ulcers, other symptoms of the disease are less specific. Among the other symptoms, which include heaviness, swelling, muscle cramps and restless legs, pain is the symptom that most frequently compels CVeD patients to seek medical aid. However, there is a substantial discrepancy between pain severity and clinically detectable signs of CVeD, questioned by several opposing studies. Further evaluation is needed to clarify this subject, and to analyse whether pain development predicts objective CVeD progression. General management of CVeD starts with advising lifestyle changes, such as lowering body mass index and treating comorbidities. However, the mainstay of treatment is compression therapy, with the additional use of pharmacological substances. Venoactive drugs proved to be the drugs of choice for symptom alleviation and slowing the progression of CVeD, with micronized purified flavonoid fraction being the most effective one. Interventional therapy is reserved for advanced stages of the disease.
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Affiliation(s)
- Djordje Radak
- Department of Vascular Surgery, Dedinje Cardiovascular Institute, Belgrade University School of Medicine, 11040 Belgrade, Serbia
| | - Igor Atanasijević
- Department of Vascular Surgery, Dedinje Cardiovascular Institute, Belgrade University School of Medicine, 11040 Belgrade, Serbia
| | - Mihailo Nešković
- Department of Vascular Surgery, Dedinje Cardiovascular Institute, Belgrade University School of Medicine, 11040 Belgrade, Serbia
| | - Esma Isenovic
- Laboratory of Radiobiology and Molecular Genetics, Institute of Nuclear Sciences Vinca, University of Belgrade, Mike Petrovica Alasa 12-14, 11000 Belgrade, Serbia
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