Venous insufficiency after prolonged standing: Is joint hypermobility an important risk factor? (original) (raw)

2015, Advanced Biomedical Research

Background: Varicose veins are extremely common disease which is due to elevated superficial venous pressures. We aimed to know that if joint hypermobility causes the venous insufficiency following the prolonged standing. Materials and Methods: This prospective cohort study conducted on the soldiers of training periods in a military base of Iran Army in Isfahan in 2013. The active-duty soldiers were first examined by a physician and their Beighton scores (BSs) were obtained. At the onset of the training period, the presence of chronic venous insufficiency was clinically evaluated according to the C class of clinical, etiological, anatomical, and pathological classification. After 3 months, soldiers with and without joint hypermobility were reexamined for manifestations of venous insufficiency based on clinical examination. Results: Of 718 soldiers, 211 subjects were diagnosed for joint hypermobility syndrome (29.3%). The mean BS was significantly higher in hypermobility soldiers (5.5 ± 1.5) than the healthy ones (1.2 ± 1.1). Before the training period, the prevalence of spider and varicose veins in soldiers with joint hypermobility was significantly higher than healthy subjects (P > 0.001). After the training period, the prevalence of venous insufficiency significantly increased in soldiers with joint hypermobility (P > 0.001) while there was no significant difference in healthy group before and after the period of training (P = 0.25). Conclusion: Hypermobility could be considered as a risk factor for the development of venous insufficiency, so it seems necessary to evaluate the population who need to be standing for a long time for evidence of joint hypermobility.

Assessment of chronic venous insufficiency using dynamic venous pressure studies

The American Journal of Surgery, 1984

With the development of reconstructive methods to treat chronic venous insufficiency due to either obstruction or valvular incompetence, accurate diagnosis of the exact venous abnormalities in a given clinical case has become necessary. We follow a diagnostic plan of off&. evaluation that includes initial history and physical examination and a screening Doppler examination, followed by dynamic venous pressure studies in the vascular laboratory. For those with clinical states that require treatment and in whom the screening studies indicate that the veins are causing the problem, definitive radiologic studies with ascending and descending venograms are performed. In this study, 207 lower limbs studied with dynamic venous pressure measurements were reviewed and correlated with the other studies obtained in each patient. The purpose of the study was to find the limits of confidence that can be ascribed to the venous pressure studies in our laboratory.

Chronic Venous Insufficiency

C hronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.

Continuous ambulatory venous pressure for diagnosis of venous insufficiency

The American Journal of Surgery, 1985

It is well known that venous hypertension results in the venous insufficiency syndrome. However, the underlying mechanism of venous insufficiency and its subsequent sequelae has been a subject of little research until recently. In the past, much emphasis was placed on static venous pressure measurements that yielded only single random values which told very little about the dynamics of the venous system. Venous pressure is an accurate determinant of venous disease, but by utilizing continuous venous pressure monitoring, it is possible to correlate pressure changes with clinical symptoms and to detect subclinical venous insufficiency.

Chronic venous insufficiency: Prevalence and effect of compression stockings

Journal of the Saudi Heart Association, 2013

Introduction: Chronic venous insufficiency (CVI) is a common disease affecting mainly lower limbs and significantly influencing the quality of life. This study aims to estimate the prevalence of CVI in the Qassim Region and test the effectiveness of compression stockings as an intervention option. Methods: A cross sectional study was conducted to assess the prevalence of CVI among patients visiting primary health care (PHC) centers in the Qassim Region. CVI patients were diagnosed and classified using the clinical, etiologic, anatomical, and pathophysiological (CEAP) scale. They were randomly divided into two groups, one using compression stockings and the other standard medical therapy. A clinical follow up was done using multiple scale system including CEAP scale. Data analysis was performed using SPSS. Results: Among the 226 screened patients, 138 (61.1%) were diagnosed as having CVI (69% female and 45% male, p<0.001). Compared to the baseline, both the clinical and venous scores for CVI at the follow-up were significantly lower among patients using compression stockings, p=0.002 and p=0.003, respectively. Regression analysis suggested that, after controlling for age, sex and body mass index, compliance was the main factor responsible for a significant reduction in the clinical score among CVI patients. Conclusions: Chronic venous insufficiency is very common in the Qassim Region. Compression stockings are highly effective in improving clinical symptoms and signs of CVI. Trial registration: This study is registered at www.clinicaltrials.gov(NCT02050061).

Prevalence of chronic venous disorders among employees working in prolonged sitting and standing postures

International journal of occupational safety and ergonomics : JOSE, 2011

Research was conducted to determine the prevalence and severity of chronic venous disorders (CVD) among people working in prolonged sitting or static standing postures. Clinical examination and duplex Doppler sonography were performed on 126 employees working in a sitting (96 individuals) or a standing posture (30 individuals). Evidence of CVD was found in 59.4% of individuals working in a sitting posture and in 83.4% of those working in a standing posture, and was significantly higher in employees working in a standing posture (p = .015). Incompetent perforating veins and vena saphena magna valves, and bilateral changes were the more frequent signs of CVD. The investigation showed that prolonged standing and sitting at work increases risk of developing CVD. Further, people working in a standing posture are at a significantly greater risk for CVD than those working in a prolonged sitting posture. They should thus be the subject of specific prophylaxis interventions.

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