New Perspectives in Phlebology and Lymphology

Cavezzi, Attilio

doi:10.3390/jcm11071902

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…We also used elastic bandages immediately after the surgery; after 24 h they were removed and replaced with compression stockings. When possible, compression (by elastic stockings or wraps) should be applied after surgical or thermal procedures [ 19 ], their role in complications prevention being acknowledged [ 20 ]. Superficial nerve injuries are very common during venous insufficiency classic surgery [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Matei

Anghel

et al. 2022

JCM

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Objective: The presentation of cryostripping as an alternative procedure useful in venous insufficiency treatment. Methods: This retrospective study presents the results of 1087 operated patients, including follow-ups. Cryostripping was practised in all mentioned cases. Patient follow-up was performed at one week, one month, and six months postoperatively by clinical examination, Doppler ultrasonography, CIVIQ-20 and r-VCSS questionnaires. Outcomes, complications, surgery and hospitalisation period, and benefits of the method were analysed. Results: Generally, good functional and aesthetic outcomes defined by clinical symptom remission, absence of insufficient veins on Doppler ultrasonography, QoL and r-VCSS improvement (p < 0.001) were obtained. Complications included bruising ⌀ < 2 cm (32.38%), haematoma (8.92%), saphenous nerve injury (3.49%), deep vein thrombosis (0.18%). Recurrence was noted in 2.94% cases. Mean duration of procedure was 42 ± 12.5 min, mean duration of hospitalisation was 1.05 ± 0.36 days. Compared to high ligation and conventional stripping, the postoperative complications were reduced; compared to other minimally invasive procedures, the costs were reduced. Conclusions: Cryostripping seems to combine the radicality and efficacy of the stripping technique with the cosmetic advantage of the endothermal procedures, being an effective therapeutic method perfectly adapted to the economic conditions of middle-income countries health system. It is also suitable as day-case surgery.

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Section: Discussionmentioning

confidence: 99%

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Matei

Anghel

et al. 2022

JCM

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“…Overall, a more comprehensive approach to the CVLD should ideally include translational medicine, epigenetics, PNEI, ANS, and HRV analysis, so to target a more patient-centered diagnostic and therapeutic pathway. 28,29,56,57,60,61,70,128…”

Section: Discussionmentioning

confidence: 99%

Compression therapy, autonomic nervous system, and heart rate variability: A narrative review and our preliminary personal experience

Cavezzi

Colucci

Barsotti³

et al. 2022

Phlebology

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Aims To highlight the relationship among compression therapy (CT), the autonomic nervous system (ANS) (parasympathetic and sympathetic system), and the heart rate variability (HRV) analysis. Background Beyond the typical analgesic and anti-inflammatory effects of CT in patients affected by venous and/or lymphatic diseases, some literature about CT influence on wellbeing has been published as well. More specifically, CT influence on the ANS has been elucidated mostly through HRV application, providing useful quali-quantitative data for scientific and clinical purposes. Material and Methods A literature search was performed through several web-based search engines to investigate the available evidence concerning the possible influence of CT on the ANS and on psychoneuroendocrineimmunology. Moreover, we examined literature data regarding HRV use in the assessment of CT. Lastly, a preliminary cross-over study was performed on 10 patients affected by phlebolymphedema of the lower limbs, undergoing CT with 18–21 mmHg stockings for 10 h and investigated by means of HRV. Results A CT-based increase of the anti-inflammatory activity of the parasympathetic (vagal) system has been elucidated in most scientific literature. Similarly, CT application has generally resulted in an improvement of HRV, which indicates a beneficial influence on the ANS. In our preliminary experience with compression stockings and HRV, two parasympathetic-based parameters improved by 22.8% and 68.0% after 10 h, whereas they decreased in the same subjects without stockings by 2.7% and 8.2%, during normal breathing. The remaining HRV parameters did not show relevant variations, especially during diaphragmatic breathing. Conclusions From literature data and based on our very preliminary experience, it is possible to deduce that CT exerts different effects on the psychobiological parameters of the individual, overall improving HRV and parasympathetic activity. Incorporating both HRV/ANS assessment in phlebolymphology and the beneficial neural action of CT in health care may represent viable options in the future biomedical science.

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“…Translational medicine, epigenetics and integrative medicine are undoubtedly future areas of interest in the treatment of chronic degenerative diseases. Incorporating these advanced approaches into the landscape of current biomedical science has the potential to be extremely beneficial and cost-effective, also in phlebolymphology where significant changes have been recently advocated 47,48 . A comprehensive approach that includes patient awareness and self-management can reduce the future burden of chronic diseases, which are destined to grow up in view of the increasing longevity.…”

Section: Discussionmentioning

confidence: 99%

Biomedical science limitations and flaws: why not choose wisely?

Cavezzi¹,

d'Errico²,

Colucci³

2022

JTAVR

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Biomedical science is experiencing a reassessment of its practices of healthcare management where more appropriate cost-benefit profiles are being combined with improvements in knowledge, effectiveness, and safety of diagnostic/therapeutic procedures to drive the advances in medicine. This review aims to assess: (a) possible biases of the scientific literature and research, (b) the clinical value and the cost-effectiveness of the principal medical practices and (c) the possible contribution of integrative and translational medicine. Literature shows that current medical research has cognitive (mostly industry-induced) biases that negatively impact clinical practice: the ever-increasing use of drugs and technologies, united with a certain inattention to the basic mechanisms of pathophysiology are paving the way of reductionism in medical practice. A critical view of innovations in medicine, together with a sound understanding and application of the scientific method, would improve the effectiveness, safety and sustainability of therapies. Translational and integrative medicine can contribute to develop a new patient-centered approach. Conversely, reductionism, eminence/reimbursement-based medical decisions, lack of patient education, industry-influenced science, and limited awareness from physicians may compromise the efficacy, safety, appropriateness, and cost-effectiveness of diagnostic and therapeutic processes.

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New Perspectives in Phlebology and Lymphology

Cited by 4 publications

References 23 publications

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Cryostripping—A Safe and Efficient Alternative Procedure in Chronic Venous Disease Treatment

Compression therapy, autonomic nervous system, and heart rate variability: A narrative review and our preliminary personal experience

Biomedical science limitations and flaws: why not choose wisely?

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