Epidemiology and Costs of Venous Diseases in Central Italy

Abstract

The Prevalence of Early Atherosclerosis study aims to define the prevalence of subclinical atherosclerosis in a typical population of central Italy. A concomitant study evaluates the prevalence of venous diseases. The prevalence of superficial and deep venous disease, the prevalence of venous thrombosis and pulmonary embolism, and the prevalence of the most common venous malformations were studied through use of medical history, a questionnaire, and noninvasive investigations. The costs of venous problems were also considered. Of some 2000 inhabitants, 746 (379 women; mean age 46.3 +/- 7 years; range eight to ninety-four) have been screened. No significant difference in trend increase of the relationship age/percent of subjects with venous problems was observed for superficial venous disease. The increase in the proportion of subjects with lipodermatosclerosis and venous ulcerations appeared to be correlated with age (r = 0.543). Evidence accepted for pulmonary embolisms was pulmonary angiogram or evidence on ventilation+perfusion lung scans. According to these criteria the number of documented deep vein thromboses and pulmonary embolisms was very limited with a larger number of suspected disease entities. There was no significant correlation between age and pulmonary embolism or deep venous thrombosis distribution. The number of venous and/or arteriovenous malformations was comparable along the age axis in the different age groups. Only a limited number of these malformations (in less that 1% of subjects) had caused a clinical problem. The treatments used for venous problems have been reported in a questionnaire and subdivided into occasional treatments and chronic treatments (when used for periods longer than twelve months). The percent of subjects using different treatment was also studied. Treatments were divided in: (1) over-the-counter products (or any treatment not requiring prescription); (2) specialized drug (for venous diseases); (3) compression; (4) surgery (any type of surgical treatment); (5) sclerotherapy; (6) combined treatments (ie, sclerotherapy and surgery); (7) alternative treatments (herbal products etc). Finally, the average costs per year for treatment, for investigations, and the costs due to lost working days were recorded. In conclusion some 12% of the evaluated population sample (male population 46%) had or had been affected in the past by a venous problem and 50% of them had received some type of treatment.

Treatment of Proximal Deep-Vein Thrombosis With the Oral Direct Factor Xa Inhibitor Rivaroxaban (BAY 59-7939)

“…In addition, investigators were advised that asymptomatic perfusion defects are frequent findings when patients with proximal DVT have routine lung scans and should not alter clinical management. 15 The protocol required patients to continue with study medications after mean day 21 (range, 18 to 26) if local review of the CCUS and lung scan results found no deterioration. However, continued study treatment was subject to the investigator's clinical judgment if local adjudication suggested asymptomatic deterioration.…”

Implementação financeira e o impacto do mutirão de cirurgias de varizes, após a criação do Fundo de Ações Estratégias e Compensação (FAEC)

“…Consequently, skin trophic lesions are reduced 5 and these patients present clinical improvements, enabling them to return to their social and labor activities, contributing to reduced socioeconomic costs 6,18 . For these reasons, higher investments in the surgical treatment of varicose veins are required to minimize or solve the problem.…”

“…Therefore, the early performance of such surgical correction can many times prevent venous diseases and reduce treatment costs 6 . With the purpose of expanding the access of the National Healthcare System (SUS) user to elective surgery, and knowing that venous diseases were potentially limiting the citizen's entry and/or stay in the labor market, the Ministry of Health (MS), through Decree 279, on April 7, 1999, created the National Campaign of Elective Surgery, for patients with lower limb varicose veins, cataract, inguinal hernia and prostate diseases 7,8 .…”

Parnaparin: review of the literature

“…Lorenzo Pradelli (1) Farmeconomia e percorsi terapeutici 2008; 9(1): [27][28][29][30][31][32][33][34][35][36][37][38][39][40] composta da piastrine e da fibrina, nella quale restano inglobate cellule ematiche.…”