Objective: To evaluate the effect of compression hosiery during standing work. Design: An open study, comparing symptoms and plethysmographic findings before and after treatment. Setting: University hospital, vascular surgery. Subjects: Forty-eight female volunteers with a standing profession. Methods: Visual analogue scale to evaluate symptoms and foot volumetry to study venous function before and after 4 weeks use of compression hosiery (20–30 mmHg). Result: All scores for symptoms were significantly reduced after treatment. Only 21% of the study subjects had minor abnormalities on foot volumetry. The expelled volume was significantly higher after work at 4 weeks than at the first measurement at inclusion, while the refilling rate was significantly lower after work at 4 weeks than at the corresponding measurement at inclusion. Conclusion: Symptomatic improvement was recorded after compression treatment. Limited effects were seen with the objective measurement, although the most important factor, the refilling rate, diminished significantly during the treatment period. Compression treatment reduces lower limb symptoms following standing work.
From ten patients aged 15 to 40 years with chronic rheumatic valvular disease and histologically proved Aschoff bodies of active rheumatic myocarditis, the valves were evaluated for incidence, distribution and degree of severity of active inflammation. Prior to death, there had been clinical evidence of active rheumatic fever. In each case, active rheumatic valvulitis was present in at least one valve. Of the individual valves studied, 83% were involved by active inflammation of the leaflets or the anulus or both. The aortic valves was involved in 100% of cases, the mitral valve in 86%, the tricuspid valve in 78% and the pulmonary valve in 70%. The mitral and aortic valves were most frequently involved, but the mitral and tricuspid valves were most severely involved when affected. In every case, active rheumatic lesions of the left atrial appendage were present, but these tended to be less widely distributed than the myocardial Aschoff bodies. The high incidence of active valvulitis supports the concept that chronic fibrosing rheumatic valvular disease results from recurrent active inflammation. Such inflammation may occur without clinical suspicion of active rheumatic fever.
It is possible to safely restore valvular competence by means of internally shrinking the vein diameter. The venous function is improved, although the vein has a tendency to increase in width with time; limited reflux reappears, with deterioration of venous function.
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