Biomedical subjects

Bo Eklof

Publications and source records attributed to Bo Eklof.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Reflux from thigh to calf, the major pathology in chronic venous ulcer disease: surgery indicated in the majority of patients.

The aim of this study was to define the underlying anatomical and pathophysiological conditions in limbs with venous ulcers in order to get information for the most appropriate treatment selection. Ninety-eight limbs (83 patients, 59 men), with active chronic venous ulcers, were analyzed retrospectively and classified according to the CEAP (clinical, etiological, anatomical, and pathophysiological) classification. Duplex-ultrasound was performed in all patients, while air-plethysmography and venography were performed selectively on potential candidates for deep venous reconstruction. Sixty-six ulcers were primary in origin and 32 were secondary. Reflux was present in all limbs except 1. Isolated reflux in 1 system (superficial = 3, deep = 4, perforator = 3) was seen in 10 legs (10%), while incompetence in all 3 systems was seen in 51 legs (52%). Superficial reflux with or without involvement of other systems was seen in 84 legs (86%), 72 legs (73%) had deep reflux with or without involvement of other systems, and incompetent perforator veins were identified in 79 limbs (81%). Axial reflux (continuous reverse flow from the groin region to below knee) was found in 77 limbs (79%). The femoral vein was the single most common deep venous segment in which either reflux or obstruction was found. Axial distribution of disease was found in the majority of cases and no patient had isolated deep venous incompetence below knee. Primary disease was the predominant etiologic cause and reflux was the main pathophysiological finding. Practically all patients were found to have 1 or more sites of reflux or obstruction that could benefit from operative treatment.

Adult↗

PubMedDate not supplied

Iliofemoral venous pressure correlates with intraabdominal pressure in morbidly obese patients.

Clinically, it has been observed that severely and morbidly obese individuals more often have venous leg symptoms related to venous stasis than normal-weight persons have. Obesity is associated with an increased intraabdominal pressure (IAP). The increased IAP in severely and morbidly obese patients would reasonably cause an elevated iliofemoral venous pressure (IFVP), which transmits via incompetent femoral veins, causing venous stasis in the lower limbs. The aim of this study was to determine whether the elevated IAP assessed by the urinary bladder pressure (UBP) corresponded with an increased directly measured IFVP. Fifteen women with morbid obesity were investigated with simultaneous UBP and direct iliofemoral vein pressures. Four normal-weight controls were investigated in the same manner. The obese patients had significantly higher UBP than the controls had, 19.1 and 8.5 cm H2O, respectively. They also had elevated IFVP compared with the controls, 19.7 and 7.5 cm H2O, respectively, and these IFVPs correlated well with the UBPs. The assumption that increased IAP in morbidly obese patients causes increased IFVP was consequently determined. To our knowledge, this has not previously been demonstrated in human individuals. How these elevated pressures contribute to the development of lower limb venous insufficiency is subject to further studies.

Abdomen↗

PubMedDate not supplied

Traveler's thrombosis: a systematic review.

BACKGROUND: Anecdotal evidence suggests a possible link between travel and venous thromboembolism (VTE). We systematically evaluated the evidence from observational studies. METHODS: We searched studies evaluating the risk of venous thrombosis in relation to traveling from MEDLINE and EMBASE up tp March 2004, together with a hand search of reference lists from retrieved literature, and we contacted some of the experts. Observational studies estimating the risks of VTE and isolated calf vein thrombosis were eligible. Methodologic quality was assessed based on prior criteria, and meta-analysis was considered where applicable. RESULTS: A total of 194 English-language publications were initially identified. Sixteen studies were included: 9 case-control, 2 prospective controlled, and 5 other observational studies. They differed drastically in study designs, selection of controls where applicable, mode and duration of travel, and subtypes of VTE under consideration. Ten studies concluded that travel, mostly through air and of prolonged duration, is a risk factor for venous thrombosis and/or pulmonary embolism, and the risk increases for passengers with preexisting venous thrombosis risk factors. Outcomes examined ranged from asymptomatic isolated calf muscle vein thrombosis to severe fatal pulmonary embolism. CONCLUSIONS: Current literature is controversial over any association between travel and VTE, and although the quality and power of these studies have been variable, studies of higher quality have shown a strong and significant association between prolonged air travel and VTE. No conclusions could be drawn about other modes of transportation. Since VTE is a disease of multifactorial causation, those with preexisting VTE risk factors are most vulnerable.

Aerospace Medicine↗