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Biomedical subjects

E Rabe

Publications and source records attributed to E Rabe.

At least 19 recordsLinked to original sources
PubMed2006

[Sclerotherapy for varicosities].

Sclerotherapy is a standard treatment for intradermal varicose veins and branch varicosities. In the treatment of insufficient saphenous veins, crossectomy and stripping used to be the methods of choice. In the last few years good results have also been reported for endovenous methods such as endovenous laser and radio frequency treatment. Sclerotherapy is more effective and even appropriate for larger saphenous veins when the sclerosing liquid is replaced by a foam agent. This cost-effective approach can be done on an outpatient basis without additional anesthesia. Prospective randomized studies are need to confirm the effectiveness.

Humans↗
PubMed2006

Endovenous laser therapy and radiofrequency ablation of saphenous varicose veins.

Radiofrequency ablation (RFA) and endovenous laser treatment (EVLT) are minimal invasive methods to treat saphenous varicose veins. The short- and mid-term results are excellent with an occlusion rate for RFA of almost 90% after 5 years and about 95% for EVLT after 2 years. Severe side effects are rare in both cases. Prospective randomised comparative studies are available for RFA and surgery showing comparable short-term results and superiority of RFA concerning short-term quality of life outcome. For laser treatment no prospective randomised comparative studies are available. Endovenous treatment is only a part of the complex treatment concept of varicose veins. Insufficient tributaries have to be treated in addition. The fact that the insufficient saphenous vein is treated without high ligation seems not to influence the short-term and mid-term recurrence rates. More prospective randomised comparative studies comparing endovenous treatment and surgery or foam sclerotherapy are necessary to decide which method is the best for which patient.

Catheter Ablation↗
PubMed2004

[Emergencies in phlebology].

Venous diseases which require emergency care include deep venous thrombosis, superficial thrombophlebitis and variceal bleeding. The clinical diagnosis of deep venous thrombosis is often inaccurate, but can be confirmed in most cases with noninvasive tools such as sonography and d-dimer testing. Standard therapy includes compression of the leg and low molecular weight heparin in a therapeutic dosage. Superficial thrombophlebitis includes a variety of disease processes involving superficial veins, some thrombotic and others inflammatory. The most important is varicophlebitis or varicothrombosis, which involves the deep venous system in up to 20% of cases. Along with immediate surgical procedures when the thrombus reaches the deep venous system in the groin, short term therapy with low molecular weight heparin can be used. Variceal bleeding is a typical complication of severe varicose veins. It can be treated by elevating the leg and compression therapy. In addition sclerotherapy or ligation of the bleeding vein can be performed.

Anticoagulants↗
PubMed2004

[Should sex specific differences in venous diseases be explained by pregnancies and hormone intake?].

AIM OF THE STUDY: Diseases of the venous system are among the most frequently occurring diseases in the German population. However, the last comprehensive population-based German data were obtained in 1979. Since then, diagnostic methods have improved substantially. Here, we examine the prevalence of venous diseases in women and their association with pregnancies and intake of hormones. METHODS: We conducted a population-based cross-sectional study in Bonn and rural environments (Recruitment period: 11/2000 - 11/2001; response: 59 %; 3072 study participants (1350 men, 1722 women), 18 to 79 years of age; investigation: standardised medical history, physical examination, duplex sonography, photography and CEAP-classification of veins of the legs). The following definitions were used: 1) Varicosis: clinical classification C2-C6 (primary varicosis only, excluding those showing spider-bursts exclusively); 2) Chronic venous insufficiency (CVI): C3-C6. For women, the risk factors examined were the number of pregnancies (P) and intake of hormones. Odds ratios (OR) and 95 % confidence intervals (95 %-CI) were calculated by multiple logistic regression (adjusted for age, region of residence and socioeconomic status). In addition, never pregnant women and men were compared regarding the two outcome variables. RESULTS: 713 participants (23 %) had varicosis and 522 (17 %) CVI. The OR for women (reference group: men) was OR = 1.4, 95 %-CI: 1.25 - 1.79 (varicosis) and OR = 1.2, 95 %-CI: 0.93 - 1.42 (CVI). There was a positive dose-response relationship between the number of pregnancies and varicosis: 1 P: OR = 1.3 (95 %-CI: 0.89 - 1.96), 2 P: OR = 1.4 (95 %-CI: 1.00 - 2.07), 3 P: OR = 1.6 (95 %-CI: 1.05 - 2.41), 4 P: OR = 1.9 (95 %-CI: 1.18 - 3.20), > or = 5 P: OR = 2.2 (95 %-CI: 1.28 - 3.74) and this trend was similar for CVI. Never-pregnant women (n = 518) and men had a similar prevalence. We did not see a consistent effect of intake of hormones in varicosis (OR = 0.9 [95 %-CI: 0.68 - 1.22]), but a negative association with CVI (OR = 0.6 [95 %-CI: 0.47 - 0.89]). CONCLUSIONS: Our results confirm the known association between diseases of the venous system and pregnancies, which seem to explain a big share of the sex-specific differences in the prevalence of these diseases.

Adolescent↗
PubMed2004

Guidelines for sclerotherapy of varicose veins (ICD 10: I83.0, I83.1, I83.2, and I83.9).

BACKGROUND: Sclerotherapy is the targeted elimination of intracutaneous, subcutaneous, and/or transfascial varicose veins (perforating veins) as well as the sclerosation of subfascial varicose vessels in the case of venous malformation by the injection of a sclerosant. With duplex-guide sclerotherapy and foam sclerotherapy, modified methods came into use. OBJECTIVE: The objective was to create a guideline, based on the available publications and on the European Consensus Document on foam sclerotherapy from April 2003. METHODS: This guideline was drafted on behalf of the German Society of Phlebology (Deutsche Gesellschaft für Phlebologie) and adopted by the committee and scientific advisory board of the Deutsche Gesellschaft für Phlebologie on June 15, 2001, and amended on December 5, 2003. The guideline considers the present state of knowledge as reflected in the literature. CONCLUSIONS: This guideline represents the recent state of the art of sclerotherapy of varicose veins in Germany including foam sclerotherapy.

Germany↗
PubMed2004

Efficacy and tolerability of an ulcer compression stocking for therapy of chronic venous ulcer compared with a below-knee compression bandage: results from a prospective, randomized, multicentre trial.

OBJECTIVE: To investigate the possibility of improving healing rates in ulcus cruris venosum by using an ulcer compression stocking (U-Stocking) (Venotrain ulcertec) as compared to compression bandages. RESEARCH DESIGN AND SETTING: Prospective, multicentre, open-labelled, randomized, active-controlled study with blinded assessment of the primary endpoint. Sixteen phlebology outpatient clinics in Germany or the Netherlands or German medical practices specialized in phlebology. PATIENTS AND METHODS: 134 patients with venous leg ulcers entered the study. Among others, patients with infected ulcer or obesity were excluded. 121 patients were eligible for primary efficacy analyses. U-Stocking or bandages applied for at least eight hours per day and for up to 12 weeks. The primary endpoint was the healing rate after 12 weeks as assessed by planimetric measures. The secondary outcome variables were time to healing, changes in ulcer size (planimetry), experience of use and patient compliance. MAIN OUTCOME MEASURES: Therapy with the U-Stocking produced a significantly higher rate of complete healing of 47.5% (29/61) versus 31.7% (19/60) with bandages, 1-sided p = 0.0129 [CI: 95% for differences: 4.3% to 28.5%]. Mean time to healing was 46 days in both groups. Time required for application of the U-Stocking was a mean of 5.4 min (SD 5.4) versus 8.5 min (SD 6.5) for bandages, p = 0.0001. Around three patients in each treatment group were affected by serious adverse events. All treatment-related adverse events are known for compression therapy. CONCLUSIONS: The U-Stocking was superior to bandages in compression therapy for venous ulcer. This is of significance to new treatment standards as well as to future studies of longer term therapy (> 12 weeks) for unhealed ulcers or prevention of recurrence.

Aged↗
PubMed2003

[Epidemiology of chronic venous diseases]].

Chronic venous diseases such as varicosis, post-thrombotic syndrome, and chronic venous insufficiency are among the most frequent clinical pictures in the Western world. The resultant consequences are persistent complaints such as a feeling of heaviness, tendency for swelling, and leg pain as well as vast skin changes culminating in an open leg ulcer. Although a series of past epidemiological studies are available, they are quite inconsistent with regard to implementation and definition of the clinical picture so that they cannot always be compared. Some are based solely on registration of disease history by questionnaires, which are inadequate to reliably assess actual prevalence. In only a very few studies are the results based on the actual examination of the subjects. Moreover, entirely difference age intervals and random samples are evaluated. The present study summarizes the most important epidemiological results with particular regard to the current Bonn Vein Study.

Adolescent↗
PubMed2002

The efficacy and safety of a coumarin-/troxerutin-combination (SB-LOT) in patients with chronic venous insufficiency: a double blind placebo-controlled randomised study.

BACKGROUND: The objective was to evaluate the oedema-protective effect of a vasoactive drug (coumarin/troxerutin [SB-LOT]) plus compression stockings in patients suffering from chronic venous insufficiency after decongestion of the legs as recommended by the new guidelines. PATIENTS AND METHODS: 231 patients were randomly assigned medical compression stockings plus SB-LOT (90 mg coumarin and 540 mg troxerutin per day) or medical compression stockings plus placebo for the first 4 weeks and SB-LOT or placebo for the second 12 weeks of the study. The primary efficacy endpoint was the lower leg volume measured by well-established water plethysmometry. RESULTS: 226 patients were evaluated. After ceasing compression stockings, an edema protective effect was detected in the SB-LOT-group but not in the controls. Recurrence of leg volume increase was by 6.5 +/- 12.1 ml and by 36.7 +/- 12.1 ml in the SB-LOT and placebo group, respectively (p = 0.0402). The local complaint score and general aspects of quality of life were also superior for the SB-LOT-group (p = 0.0041). Significant differences were also observed with regard to clinical global impression and therapeutic effect. No serious adverse drug reaction or clinically relevant impairment of laboratory parameters occur. CONCLUSION: This study confirms the oedema-protective effect of SB-LOT in chronic venous insufficiency and provides a treatment option for patients who discontinue compression after a short time.

Administration, Oral↗
PubMed1999

Annular erythema caused by impending pacemaker extrusion.

A 72-year-old patient with an implanted cardiac pacemaker presented with a circumscribed erythematous area on his chest. It was only several months later, after he had developed positional, localized pain in this area, that the diagnosis of an impending pacemaker extrusion became evident. This case illustrates the diagnostic difficulties in patients with pacemaker-associated skin lesions. Regular follow-up examinations and close co-operation of dermatologists, cardiologists and cardiothoracic surgeons are of major importance in view of the potentially life-threatening complications.

Aged↗
PubMed1999

Embolia cutis medicamentosa of the foot after sclerotherapy.

Typically, embolia cutis medicamentosa is reported after intramuscular injections of drugs. We describe a case of embolia cutis medicamentosa after sclerotherapy of intracutaneous veins of the foot with a polidocanol solution of 1%. Under therapy with intravenous alprostadil, pentoxifyllin, internal steroids and anticoagulation with heparin, the lesions healed completely without necrosis.

Aged↗
PubMed1998

Contact sensitization in chronic venous insufficiency: modern wound dressings.

Patch tests with an expanded European standard series and 20 different wound dressings revealed sensitization in 78% of all (36) patients. The charts of allergens were headed by ointment bases (wool wax alcohols sensitization in 33% of all patients; Amerchol L-101 19.4%; cetearyl alcohol 13.9%; propylene glycol 8.3%), followed by plant resins/ethereal oils (balsam of Peru 22.2%; colophony 13.9%, fragrance mix 8.3%; propolis 5.6%) and topical antibiotics (neomycin sulfate 16.7%, chloramphenicol 13.9%), while usually common sensitizers like metal salts were not found as often (nickel sulfate 16.7%; potassium dichromate 13.9%; cobalt chloride 5.6%). Sensitization to modern wound dressings was found in 8.3% (3 cases) and was caused by propylene glycol as an ingredient of hydrogels; no sensitization was found to hydrocolloids, alginates or polyurethane foams. The overall sensitization rate in 2nd degree CVI was nearly as high as in 3rd degree CVI, but sensitization to ointments, their additives and topical antibiotics was significantly higher in 3rd degree CVI. Significant differences in sensitization frequencies to individual allergens were found between male and female patients. Our investigation points out the high risk of sensitization in 2nd as well as 3rd degree CVI, especially to ointment bases and active principles of topical drugs. Even wound dressings may cause allergic contact reactions.

Adult↗