[Value of venoactive substances in phlebology. Treatment of varicose veins and post-thrombotic syndrome].
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Biomedical subjects
Publications and source records attributed to G Rudofsky.
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In a double blind, randomized multicenter study naftidrofuryl, a vasoactive substance, was compared with placebo in the treatment of 104 patients with chronic arterial occlusive disease. After a run-in period of four weeks the patients received either naftidrofuryl (600 mg daily) or placebo over 12 weeks. The pain-free and the total walking distances improved significantly in both groups. However, the difference in the improvement of the pain-free walking distance was significant (p less than 0.02) in favour of naftidrofuryl. There also was a difference in the improvement of the total walking distance in favour of naftidrofuryl which was not significant. The results indicate that naftidrofuryl has a beneficial effect on the symptoms and lengthens the painfree walking distance in patients with arterial occlusive disease.
The activity of the fixed combination Phlebodril on the venous hemodynamic system was studied in 20 healthy volunteers. A different reaction was seen. One part of the volunteers showed a significantly reduced venous capacity whereas the other part presented an increase in venous storage ability. This effect especially was observed after application of trimethylhesperidinchalcone, which increases the capillary resistance.
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1. Clinical and haemodynamical checking has shown that no negative influence on the result of re-implantation is exercised by safeguarding the venous flow via a single anastomosis at the back of the finger (success quota 82%). 2. One venous thrombosis only occurred as a result of the surgical procedure mentioned above, in 18 reimplanted fingers (5,5%); hence, the quota of venous thromboses is definitely lower than with other reported groups of patients (2, 6). 3. Anastomosing of one dorsal vein only in the reimplantation of long fingers and thumb can, therefore, be recommended as a simplified routine method.
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In an open clinical trial 14 patients with intermittent claudication caused by an obliteration of the femoral artery received 400 mg pentoxifylline 3 times daily over a period of 6 months. The walking distance, time to peak flow and calf ergometry showed a significant increase. Minor improvement of working hyperemia and peak flow could be found. The systolic pressure gradient over the obstruction didn't change. No patient complained about side effects.
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Measurement of the venous capacity by means of strain-gauge-plethysmography when performed under standardised conditions produces reproducible values in chronic test also. Acutely, the venous capacity of the healthy can be reduced by cold water and increased by warm water appplication. When measuring pressure in the great saphenous vein, which was performed during stress test and after cooling down, a clear improvement of the valvular function in the shank coud be ascertained. The healthy lying down, a distinct increase of the venous tonus takes place after application of cold water. With respect to primary varicosis, in addition to the acute reduction of volume, a chronic training effect, in the sense of a reduction in the venous capacity, significantly can be a convenient means for the treatment of primary varicosis and of less severe forms of chronic venous insufficiency.
In 2 patients with Echinococcus alveolaris of the liver an angiography of the celiac axis, superior mesenteric artery and -- indirectly -- of the splenic vein was performed. The findings -- obliteration, dislocation, corc screw collaterals -- are not diagnostic. This statement is supplemented by a review of the special literature. The value of an arterial angiography consists in delineating the extent of the process. In this sense the method seems to be superior to a liver scan. Angiography is indicated when curative surgical therapy is discussed.
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