Superficial vein thrombosis is characterized by clotting of superficial veins (ie, following direct trauma) with minimal inflammatory components. Superficial thrombophlebitis is a minimally thrombotic process of superficial veins associated with inflammatory changes and/or infection. Treatments generally include analgesics, elastic compression, anti-inflammatory agents, exercise and ambulation, and, in some cases, local or systemic anticoagulants. It is better to avoid bed rest and reduced mobility. Topical analgesia with nonsteroidal, anti-inflammatory creams applied locally to the superficial vein thrombosis/superficial thrombophlebitis area controls symptoms. Hirudoid cream (heparinoid) shortens the duration of signs/symptoms. Locally acting anticoagulants/antithrombotics (Viatromb, Lipohep, spray Na-heparin) have positive effects on pain and on the reduction in thrombus size. Intravenous catheters should be changed every 24 to 48 hours (depending on venous flow and clinical parameters) to prevent superficial vein thrombosis/superficial thrombophlebitis and removed in case of events. Low molecular weight heparin prophylaxis and nitroglycerin patches distal to peripheral lines may reduce the incidence of superficial vein thrombosis/superficial thrombophlebitis in patients with vein catheters. In case of superficial vein thrombosis/superficial thrombophlebitis, vein lines should be removed. In neoplastic diseases and hematological disorders, anticoagulants may be necessary. Exercise reduces pain and the possibility of deep vein thrombosis. Only in cases in which pain is very severe is bed rest necessary. Deep vein thrombosis prophylaxis should be established in patients with reduced mobility. Antibiotics usually do not have a place in superficial vein thrombosis/superficial thrombophlebitis unless there are documented infections. Prevention of superficial vein thrombosis should be considered on the basis of patient's history and clinical evaluation.
The aim of this study was to evaluate the prevention of recurrent deep vein thrombosis (R-DVT) with an oral antithrombotic agent (sulodexide) in moderate to high-risk subjects. A group of 405 patients was included into the multicenter registry. Both compression and an exercise program were used as well as a risk-factors control plan. After diagnosis of DVT, patients were treated with oral anticoagulants for 6 months. At the end of this period a coagulation study was made and patients started treatment with oral sulodexide capsules for a period of 24 months. The femoral, popliteal, tibial, and superficial veins were scanned with high-resolution ultrasound at inclusion;scans were repeated at 6, 12, 18, and 24 months. Of the 405 subjects included into the registry 178 in the control group (mean age 52.2; SD 11; M:F=90:88) and 189 in the treatment group (mean age 53.2; SD 10.3; M:F=93:96) completed the analysis period of 24 months. At 6 and 12 months the incidence of R-DVT was lower (p<0.05) in the treatment group. At 24 months the global incidence of R-DVT was 17.9% in the control group and 7.4% in the sulodexide group (p<0.05), 2.42 times lower than in controls. The 2 groups were comparable for age and sex distribution and for the localization of the thrombi at inclusion. Also the 2 groups of dropouts were comparable. In the control group there were 32 recurrent DVTs and 24 subjects lost to follow-up (total of 56) of 202 included subjects (27.7%) in comparison with 28 failures (14 recurrent DVTs and 14 lost subjects) of 203 subjects (13.8%) in the treatment group. This difference was statistically significant. In this analysis the incidence of DVT in controls was 2.07 times higher than in the treatment group subjects. In conclusion sulodexide was effective in reducing recurrent thrombotic events in high-risk subjects.
*As políticas de gestão das migrações internacionais no continente Europeu são o foco do livro Rebus Immigrazione de Giuseppe Sciortino, professor de sociologia na Universidade de Trento. O livro, não muito extenso, prioriza uma abordagem histórica, buscando interpretar o universo dos deslocamentos populacionais à luz do "meio ambiente" demográfico, cultural, político, econômico e jurídico de referência.Desde a Paz de Augusta, no século XVI, até os recentes Regulamentos de Dublin, o gerenciamento das migrações foi caracterizado por tensões e conflitos, principalmente no que se refere à dialética entre o direito de migrar dos indivíduos e o direito dos estados de determinar quem pode entrar e residir em seu território. Essa tensão, ainda hoje não resolvida, molda os desafiadores processos de negociação na elaboração e implementação das políticas migratórias.Mas não é a única tensão. De acordo com Sciortino, as atuais políticas migratórias de contenção, apesar de limitar sensivelmente os deslocamentos, não alcançam plenamente seus objetivos basicamente por três fatores estruturais: a tensão entre os sistemas políticos e a economia de livre mercado; a tensão entre a vontade política particularista e o ordenamento jurídico focado em princípios universalistas; a tensão gerada pelas radicais desigualdades em * Centro Scalabriniano de Estudos Migratórios (CSEM) de Brasília. Brasília, DF, Brasil.
Mobilizações de migrantes e refugiados: as lutas pela visibilidade e pelo reconhecimento A multiplicação de movimentos populares de luta e resistência em nível mundial é sinal do exacerbado crescimento do número de pessoas que são-e têm consciência de serem-prejudicadas ou violentadas pela ordem hegemônica assimétrica em nível local ou planetário. Para além do tradicional-e ainda atual-conflito entre capital e trabalho, novos movimentos sociais surgem em resposta à depredação do meio ambiente, à discriminação ou menosprezo dos direitos fundamentais de determinados grupos sociais como mulheres, LGBT, povos autóctones, minorias, entre outros. Ainda que frequentemente silenciados pela imprensa internacional, é suficiente citar os movimentos de protesto e reivindicação de Chiapas (1994), de Seattle (1999), a assim chamada "Primavera árabe" (2010), o movimento dos Indignados na Espanha (2011), os recentes e maciços protestos na França e no Brasil (2016). Em meio a tudo isso, chama a atenção também a "primavera" das mobilizações de migrantes e refugiados. Trata-se de atos de protesto e reivindicação que, embora bastante heterogêneos em termos de atores, interlocutores, objetivos e mediações, visam fundamentalmente à busca pela visibilidade e pelo reconhecimento.
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