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Biomedical subjects

P L Antignani

Publications and source records attributed to P L Antignani.

At least 19 recordsLinked to original sources
PubMed2004

Results of a questionnaire regarding improvement of 'C' in the CEAP classification.

BACKGROUND: One of the shortcomings of the CEAP classification is that some of the clinical conditions in the original version were not defined and, therefore, were used in different ways by those who work with CEAP. AIM: To clarify the definitions of the seven clinical classes in the CEAP classification and to improve universal understanding of these in phlebology. METHODS: The authors prepared a short questionnaire regarding the 'C' part of CEAP with five main questions, dealing with definitions of clinical items: telangiectases, corona phlebectatica, reticular veins, varicose veins and the use of CEAP. The questionnaire was translated into 11 different languages and sent around the world by means of International Venous Digest by fax. Two hundred and six answers were received from 67 countries out of 3681 faxes sent (5.6%). RESULTS: There were a wide variety of opinions returned thus demonstrating that the same term is used with various meanings by different physicians. All physicians classify telangiectases of thigh and foot as class C1, but discrepant answers were obtained concerning the differences between reticular veins and reticular varicose veins as well as the diameter of small and large varicose veins. Sixty per cent of physicians answering this survey use the CEAP classification. CONCLUSION: Further clarification and refinement of the CEAP classification are necessary. The authors hope that this will result in broader acceptance of CEAP.

Humans↗
PubMed2003

Treatment of chronic peripheral arterial disease.

Peripheral arterial disease (PAD) is a common but under-recognized problem. Intermittent claudication is the most frequent symptom of PAD, although the diagnosis of PAD is often overlooked until the patient is presented with limb-threatening ischemia. Importantly, PAD is a marker of generalized atherosclerosis and is closely associated with coronary and cerebrovascular disease. The primary causes of death in patients with PAD are myocardial infarction and stroke. Reducing risk factors is an integral and aggressive part of the treatment regimen. The recognition and diagnosis of PAD, combined with its appropriate medical management, may well reduce the overall risk of cardiovascular morbidity. When diagnosed early, both exercise and pharmacotherapy can ameliorate symptoms of claudication. augment functional performance, and improve quality of life. This review focuses on the general medical management and specific therapeutic options. Because PAD is a manifestation of generalized atherosclerosis, the principal issue in medical management of PAD is a treatment plan that modifies known risk factors for atherosclerosis and its atherothrombotic complications. All patients with PAD should be receiving antiplatelet therapy to prevent ischemic events and ACE inhibitors should be used if appropriate. Medical treatment for patients with claudication includes exercise in rehabilitation and drug therapy. It is also recognized that selected patients with claudication symptoms may benefit from catheter-based interventions, and most PAD patients with critical leg ischemia require revascularization procedures. Although many therapies for claudication have been thoroughly investigated, research continues on new treatments. In contrast, more prospective, randomized trials are needed to evaluate various therapies for treating patients with PAD.

Arterial Occlusive Diseases↗
PubMed2001

Classification of chronic venous insufficiency: a review.

Chronic venous insufficiency (CVI) is a very variable and complex entity that has stimulated different attempts at classification. Several proposals have been made in recent years, based on objective and anatomical criteria, most of them incomplete and unsatisfactory. Finally the CEAP classification was presented in 1994. This certainly is the most nearly complete classification, since it takes into consideration not only the main aspects of CVI: Clinical, Etiological, Anatomical, and Pathophysiological, but also the degrees of severity, reported in the form of scores. It is now accepted internationally although it still has some flaws (such as the absence of the corona phlebectactica sign) and inaccuracies (above all in the clinical part and the scoring). Recently, some members of the Promoting Committee proposed a substantial modification of the part on scores, coming closest to the clinical reality, instrumental diagnosis, and current therapies. The characteristics of CEAP enable us to affirm that this represents the most original and useful classification, not only for clinical studies, but also in the assessment of therapeutic results and in patient follow-up. Like all classifications, CEAP also needs to be validated by means of clinical studies in order to demonstrate its applicability. For this purpose, a European Working Group was set up in 1997. The first interesting results of 872 dossiers collected by means of a computerized program (European Phlebological File) were presented at several international congresses and concentrated on the consistency and reproducibility of the clinical part of the CEAP classification in different clinical settings.

Chronic Disease↗
PubMed1999

Association between Takayasu's arteritis and Crohn's disease in two young women: case reports.

Among 34 patients under observation, two young women, aged 23 and 24, developed Takayasu's disease (Takayasu's arteritis) associated with Crohn's disease. The typical vascular symptoms of Takayasu's arteritis developed late during a quiescent phase of Crohn's disease. We discuss the usefulness of diagnostic methods, particularly the contribution of duplex Doppler. Currently, this method appears to provide effective diagnosis of Takayasu's arteritis although clinical data, including hyposphygmy of the radial arteries and carotidynia (pain appearing along the carotid course) are still fundamental. The possible etiopathogenic relations between these two diseases and correlation of results with those in the literature are discussed (J Mal Vasc 1999; 24: 373-376).

Adult↗
PubMed1997

[Chronic venous pathology: presentation of a new international classification].

The Authors present a new classification of chronic venous pathology. The first presentation was in Maui during the Congress of the North American Society of Phlebology and the second in London, during the last World Congress of International Union of Phlebology. The aim is to standardize the clinical and instrumental data to propose a common classification to all physicians. Etiological, anatomical, physiopathological and clinical findings were considered.

Chronic Disease↗
PubMed1997

[Epidemiology and clinical framework of the ischemic pathology of the lower limbs].

The atherosclerotic disease is a very important problem for the health in the advanced countries. The Rose's questionnaire was utilised for diagnosing the intermittent claudication but the current diagnostic method is the ankle-arm blood pressure ratio (Winsor's index). The incidence of intermittent claudication is 0.4% to 14.4%, utilising the Rose's questionnaire and 4.2% to 35% using the Winsor's index. The main risk factor for the peripheral arteriopathies is the smoke followed by the hypertension and the diabetic disease. The dyslipidemic and coagulative diseases are important risk factors in some populations. The main cause of death is the myocardial infarction. The risk increases when it is present a cerebral or coronary arterial pathologies.

Adult↗
PubMed1996

[The extra- and intracranial correlations of cerebral hemodynamics].

The transcranial Doppler method, at the present, allow us to study, in non-invasive way, the cerebral haemodynamics and its changes in case of extra- and intracranial vascular disease. The correlations between the intracranial data, obtained by means the transcranial doppler, and the informations, received by the duplex Doppler ultrasound and the color doppler ultrasonography, permit us to effect a complete and correct assessment of the cerebral circulation and to indicate an efficient medical or surgical therapy. The valuation of the compensatory intracranial circulation and the cerebral vasodilatator capacity is very important to establish the degree of cerebrovascular damage. Finally the transcranial Doppler allow us an indirect valuation of the intracranial lesion of the circle of Willis.

Brain↗
PubMed1995

The syndrome of the "coup de fouet". Is it always a benign disease?

BACKGROUND: The "coup de fouet" syndrome is an uncommon condition characterized by a spontaneous intramuscular venous hemorrhage of the calf, sometimes accompanied by a deep thrombosis of the leg. OBJECTIVE: The purpose of this work is to verify the real incidence of the thrombotic complications, making use of the most recent noninvasive diagnostic instruments, such as the duplex scanner and color Doppler. METHODS: From January 1992 to December 1993, we examined 24 subjects (average age, 38.5 years) suffering from the so-called "coup de fouet" syndrome, which had appeared during physical activity: walking (nine cases), running (six cases), and sudden changes of position (nine cases). In all cases we performed a clinical and instrumental examination (analogical and tensive arterial and venous Doppler, arterial and venous duplex scanner, and color Doppler). RESULTS: Clinically we found, in 17 subjects, a hematoma in the posterior calf with increased thickness and, in 10 cases, with spontaneous sharp pain. In the other seven cases we found a modest hematoma without subjective or other objective symptoms. The arterial Doppler and scanner findings were normal. In the first group of 17 cases, the average clinostatic Doppler venous pressure, measured using a method developed by us and already described, was 32 +/- 4 mm Hg (normal value, 15 +/- 7 mm Hg); in the other seven cases the value was 19 +/- 4 mm Hg. CONCLUSION: The duplex scanner and color Doppler examination confirmed in all subjects the presence of an intrafascial hematoma in the gemellar zone; in 10 cases (41.7%), with more painful symptomatology, in a zone contiguous to the hemorrhage, we found a gemellar (six cases) or popliteal (four cases) phlebothrombosis. Lastly, we must point out that the syndrome is not always benign and that, therefore, a correct and more vigilant diagnostic and therapeutic approach is necessary.

Adult↗
PubMed1993

Light-reflection rheography and acute deep vein thrombosis.

The authors examined 47 subjects affected by acute phlebothrombosis of the lower limbs by means of light-reflection-rheography (LRR). The diagnosis was based on the results of clinical, Doppler, and duplex scanner evaluations. The results were compared with those obtained in 30 healthy subjects (control group). The LRR examinations were performed by two methods: the one consisting of a passive execution of postural movements of the limb, the other using the technique of plethysmographic venous occlusion. The pathological LRR curves were characteristic for each type of disease and for the site of thrombosis and were different from the normal ones. The results obtained show the usefulness of the method and it potential in studying the collateral circulation and the effects of different therapies.

Acute Disease↗
PubMed1990

Light reflection rheography and thoracic outlet syndrome.

The authors have studied with a light reflection rheograph (LRR) 112 cases: 54 patients with suspected "thoracic outlet syndrome" (TOS) in the functional phase, 28 patients with phlebothrombosis localized in upper limbs, and a control group of 30 healthy subjects to evaluate the upper limbs' venous outlet. They recorded a good correlation among results obtained with LRR, clinical examination, Doppler, and phlebographic examination. The data obtained lead them to propose this methodology as an important examination in the evaluation of upper thoracic pathology.

Adult↗