Objectives: The aim of this study was to evaluate occlusion rates of great saphenous veins (GSV) with a diameter between 5-10 mm that received a pre-treatment size reduction via perivenous tumescent application (TA) followed by catheter-directed foam sclerotherapy (CDFS).Methods: A prospective blinded randomized clinical trial comparing the occlusion rates of GSV at 1-, 6-, and 12-month follow-up. Fifty patients were included and randomized into two groups. CDFS was performed accessing the GSV at knee level and applying 8 mL of 2% polidocanol-foam (EasyFoam) while the catheter was withdrawn. Strictly perivenous TA was performed in group 1 before applying the sclerosant agent. Occlusion rates and clinical scores were assessed by blinded examiners.Results: After 12 months in group 1 full occlusion was achieved in 73.9%, partial occlusion in 8.7%, and 17.4% were classified as treatment failure. In group 2, 75% of the targeted GSV were fully occluded, 20% were partially occluded, and 5% were diagnosed as treatment failure. Both groups showed a significant reduction of the vein diameter. Patient's tolerance and satisfaction with the treatment was high in both groups.Conclusion: No benefit could be found using additional TA to reduce the vein diameter before the treatment. The Effect of Different b-Blockers on Vascular Graft Nitric OxideLevels: Comparison of Nebivolol Versus Metoprolol Bayar E., Ilhan G., Furat C., Atik C., Arslanoglu Y., Kuran C., Ozpak B., Durakoglugil M.E. Eur J Vasc Endovasc Surg 2014;47:203-7.Objectives: The aim of this study was to investigate the effects of the vasodilating b-blocker nebivolol and the cardioselective b-blocker metoprolol on nitric oxide (NO) levels at vascular graft endothelium and vasa vasorum compared to controls in patients undergoing coronary artery bypass graft surgery.Methods: This was a prospective study. Fifty-five patients were divided into three groups: nebivolol group (group N, n ¼ 23), metoprolol group (group M, n ¼ 16), and control group (group A, n ¼ 16). Group N received nebivolol 5 mg once daily, and group M received metoprolol 50 mg once daily for 15 days in the preoperative period. Control patients did not use b-blocker therapy. Tissue samples of both left internal mammary artery (LIMA) and saphenous vein grafts were investigated for NO activity using immunohistochemical methods.Results: Demographic characteristics and risk factors were similar between groups. We observed the highest NO activity in group N in both endothelial and vasa vasorum samples of LIMA and saphenous veins. NO activity of metoprolol group was similar to controls.Conclusions: According to our results, we think that nebivolol may be safer and preferable in order to diminish graft spasm in patients undergoing coronary artery bypass graft surgery due to the NO-mediated vasodilating effect. JOURNAL

Objective:The aim of this study was to demonstrate the efficacy of the anti-tumor necrosis factor agents, adalimumab and infliximab, in patients with Crohn's disease and ulcerative colitis and to evaluate the efficacy duration and safety of remission maintenance in both diseases. Methods: This is a case-controlled, cross-sectional study conducted on patients with Crohn's disease and ulcerative colitis followed up by the gastroenterology outpatient clinic. The clinical information, demographic data, laboratory values, and colonoscopy findings were analyzed prior to initiation and at 12 months after the use of infliximab and adalimumab. With these analyses, Crohn's Disease Activity Index score for Crohn's disease and Seo score for ulcerative colitis patients were calculated. Results:The study included a total of 61 cases, 33 male (54.1%) and 28 female (45.9%) patients, who met the inclusion criteria, with a mean age of 36.44 ± 12.47 years. In this study, 37 (60.7%) Crohn's disease and 24 (39.3%) ulcerative colitis patients were included, 40 of whom use infliximab and 21 of whom use adalimumab. When the endoscopic scoring, laboratory data, and clinical scores (Crohn's Disease Activity Index P = .002 in infliximab users, SEO score P = .001; Crohn's Disease Activity Index P = .001 in adalimumab users, SEO score P = .102] at the start of anti-tumor necrosis factor therapy (month 0) and at month 12 of treatment were compared, infliximab and adalimumab treatments have been shown to be effective in remission. Conclusion: According to our results, the initiation of anti-tumor necrosis factor therapy seems to be an effective approach when remission cannot be achieved with other conventional treatments in patients with Crohn's disease and ulcerative colitis.