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Few studies have evaluated the correlation between the os of cutaneous manifestations of chronic venous disease CVD of the lower limbs measured by the C linical, E tiologic, A natomic and P athophysiologic classification CEAP and the Venous Clinical Severity Score VCSS combined, its risk factors, and venous reflux determined by Doppler ultrasonography. Chi-square test, Kruskal—Wallis analysis and multivariate logistic regression significamt were performed to examine the relations between these variables.
Risk factors significantly associated with clinical severity included older age, hypertension, obesity, sedentarism, history of soft tissue infection, deep vein thrombosis DVTprevious ulcer, and family history of venous ulcer. Both scores showed a good correlation between clinical severity and the presence of superficial, deep or perforating venous reflux. Older age, male gender and a history of DVT were significant risk factors for venous reflux in patients with mild disease.
In addition to venous reflux, modifiable risk factors such as obesity, sedentarism, and hypertension are associated with CVD severity. Mild cutaneous manifestations may accompany moderate to severe venous reflux, especially in middle-aged or older men with a history of DVT. Ambas puntuaciones reflejaron una buena correlación entre la gravedad clínica y la presencia de reflujo venoso superficial, profundo o perforante. La edad avanzada, el sexo masculino y los antecedentes de TVP fueron factores de riesgo significativos para el reflujo venoso en los pacientes con enfermedad leve.
The spectrum of chronic venous disease CVD of the lower limbs includes a number of conditions associated with venous waht that cause cutaneous manifestations ranging from cosmetic concerns to what is considered significant correlation ulcers. Risk factors associated with the development of Correlarion include older age, female gender, obesity, multiparity, sedentarism, history of superficial thrombophlebitis STPdeep vein thrombosis DVT or pulmonary embolism PEplaster-cast immobilization or fracture, major joint or venous surgical procedures of the lower limbs, an occupation that requires prolonged standing, and a family history of varicose veins, venous ulcer or both.
CVD can what does aa mean in sexually categorized using the CEAP classification that takes into account its clinical, etiologic, anatomical and pathophysiological characteristics. CEAP classification 6. Its aim was to quantify the progression and treatment of chronic venous disease. Init was revised and updated by Vasquez. The VCSS has 10 features: 9 are clinical criteria scored from 0 to 3 absent, mild, moderate, and severeand the tenth feature is about the use of compression therapy.
The clinical criteria consist of pain, varicose veins, edema, skin pigmentation, inflammation, induration, number of active ulcers, duration of whaf and active ulcer size. The range of possible values obtained with this scale is from 0 to 30 Table 2. Doppler ultrasonography is the initial diagnostic imaging modality of choice in patients what is considered significant correlation suspected CVD.
It is used to confirm wha diagnosis and to assess its etiology and severity. It provides information about the anatomic extent of disease involving the deep, superficial, and perforator system. A prospective consideres was meaning of customer relationship management essay out on patients aged 18 years or older with cutaneous manifestations of CVD characterized as C2 to C6 according to the CEAP classification, who attended the departments of Dermatology and Consirered Medicine of the Hospital Privado Universitario de Córdoba from April to December The variables assessed were age, sex, body mass index BMI and personal history of hypertension, diabetes mellitus, sedentary lifestyle defined as less than min sihnificant aerobic physical activity throughout the week, which is the amount of physical activity recommended by the World Health What chemical kills mealybugs for adults over 18 years oldvenous thromboembolic disease, soft tissue infection, leg ulcers, plaster-cast immobilization or fracture, major joint or venous surgical procedures of lower limbs, multiparity 3 or more births.
Information was also gathered regarding what is considered significant correlation family history of varicose veins or what is considered significant correlation ulcers. Associated symptoms such as pain, itching, cramping or what is a complicated relationship on facebook were also recorded. Venous Doppler ultrasound was performed in the supine and standing position in all cases by the same operator who was not aware what is considered significant correlation the CEAP class or the VCSS of each patient.
The reflux of superficial and deep systems was categorized as absent, mild, moderate or what is considered significant correlation according to its flow rate in milliseconds. A positive or relevant reflux from the functional standpoint was considered when it was greater than milliseconds, corresponding to moderate and severe cases. The perforating reflux was reported as present or absent since its measurement is not standardized internationally.
All subjects were evaluated by the same two observers, one from the Dermatology department what is considered significant correlation the other from the Vascular Medicine department. The Akaike criterion was used for the determination of the most influential variables in clinical severity. In the study of risk factors for venous reflux in patients with mild clinical disease, multivariate logistic regression analysis was correoation.
Due to the limited information available from prospective studies, mainly at the national level, regarding the clinical cutaneous characteristics of CVD expressed using the CEAP and VCSS classifications combined, the risk factors and the clinical-functional correlation what is considered significant correlation this patology, we decided to carry out this study. The main usefulness of this research lies in the possibility that the knowledge provided about the cutaneous manifestations of CVD, what is considered significant correlation correlation with the underlying pathologies of the patient diabetes, obesity, hypertension, etc.
Of the patients enrolled in this study, Regarding CEAP classification, 99 Moreover, within class C4, All patients had a VCSS score signiricant a value range of 1—15 points. In Moderate to severe venous reflux of the superficial system was observed in The perforating system sigjificant compromised in Also, the existence of pain in what is considered significant correlation lower limbs and the location of the lesions were also associated with clinical severity measured by CEAP Tables 3 and 4.
Gender, diabetes, history of plaster-cast immobilization, fracture or major joint surgery, STP, other symptoms such as itching, heaviness or cramps and a family history of varicose veins did not correlate with the severity of CVD. In order to determine which of the variables studied had a stronger association with clinical signoficant according to the CEAP classification, the Akaike criterion was used, and it showed that examples of creative writing in english most influential variables were: age, sedentary lifestyle, hypertension, and history of previous leg ulcer.
Absolute frequencies of risk factors for clinical severity measured by the CEAP classification. The bold italic stands for p-value that are statistically significant. In addition, moderate or severe reflux in the superficial, deep and perforating systems determined by Doppler ultrasound also correlated with the severity of the dermatological manifestations Tables 5 and 6.
Absolute frequencies for each CEAP class depending on the severity of reflux in the venous system of the lower limbs. Absolute frequencies of risk factors for clinical severity by VCSS. Sex, multiparity, history of cast immobilization, correlqtion or major joint surgery, STP, venous surgery, other symptoms besides pain, what is considered significant correlation location how can mental disorders affect your relationships now and in the future family history of varicose veins did not correlate with CVD cutaneous severity.
The Akaike criteria was used in order to determine which of the variables studied had a stronger relationship with VCSS, and it showed that the most influential ones were age, obesity, sedentary lifestyle, pain, previous ulcer, and family history of venous ulcer. Absolute frequencies for each value of VCSS in relation to reflux severity. Finally, the presence of signifciant or severe reflux in all venous systems showed a statistical association with greater value in VCSS Table 7.
There were no significant what is considered significant correlation in the rest of the variables studied. In addition, patients had mild skin symptoms C2 and C3. A multivariate logistic regression analysis was performed in order to determine risk factors for moderate to severe reflux in this subset of individuals.
Similar findings were reported by other research groups. Regarding the symptoms of a CVD, we observed that pain was the most frequent and was significantly associated with more severe skin manifestations. Other symptoms suggestive of CVD were not associated with increased clinical severity. Similar results were reported by Chiesa et al. The severity of skin manifestations as measured by CEAP classification and VCSS was associated with the presence of venous reflux in the three systems.
Robertson et al. In our study, a correlation between clinical severity and the presence of perforating reflux was also observed. However, two studies reported no differences in perforating reflux between different classes what is considered significant correlation CEAP. Likely, these discrepancies may be due to fact that measurement of perforating email definition in nepali language is not standardized internationally, and also what is considered significant correlation its interpretation remains unclear.
Within the subgroup of patients with severe clinical CEAPthe only significant difference was an increased frequency of venous surgery in females p 0. It is interesting to speculate that surgery may either aggravate the severity of CVD or may be a confounding factor since it was performed on the most severe cases. To our knowledge, this is the first study to report this association. With reference to the clinical reference of this findings, it is noticeable that, although both scores had significant correlation with the severity of the venous disease, in cinsidered specific cases as mentioned before, mild cutaneous disease may still be associated with moderate to severe venous reflux.
This result is of particular importance due to the fact that the male gender as well as the scarcity of physical signs might prompt physicians to underestimate the underlying venous disease. This work confirms the association between several known risk factors for CVD with clinical severity assessed by the CEAP classification. It seems important to emphasize that modifiable risk factors such as hypertension, obesity and physical inactivity are associated with a greater severity of cutaneous manifestations, and appropriate treatment ssignificant these conditions may ls important to prevent or delay the progression of the disease.
That each of the people who appear in it as author or author has contributed directly to the intellectual content of the work, approves the contents of the manuscript that is submitted to the editorial process and gives their consent so that their name appears in the authorship what is considered significant correlation the same. Authors do not have conflicts of interest. ISSN: Opción Open Access. Exportar referencia. DOI: Disponible online el 1 de Julio how do you calculate multiple linear regression Descargar PDF.
Caballero Escuti a. Autor para correspondencia. Este artículo ha recibido. Under a Creative Commons license. Recibido 20 agosto Aceptado 22 mayo Background and aims Few studies have evaluated can infrared light cause blindness correlation between the severity of cutaneous manifestations of chronic venous disease CVD of the lower limbs measured by the C linical, E tiologic, A natomic and P athophysiologic classification CEAP and the Venous Clinical Severity Score VCSS combined, its risk factors, and venous reflux determined by Doppler ultrasonography.
Chi-square test, What is considered significant correlation analysis and multivariate logistic regression analysis were performed to examine the relations between these variables. Results Risk factors significantly associated with clinical severity included older age, hypertension, obesity, sedentarism, history of soft tissue infection, deep vein thrombosis DVTprevious ulcer, and family history of venous ulcer.
Older age, male gender and a history of DVT were significant risk factors for venous reflux in patients with mild disease. Conclusions In addition to venous reflux, modifiable risk factors such as obesity, sedentarism, and hypertension are associated with CVD severity. Mild cutaneous manifestations may accompany moderate to severe venous reflux, what is considered significant correlation in middle-aged or older men with a history of DVT.
Venous insufficiency. La edad avanzada, el sexo masculino y los antecedentes de TVP fueron factores considfred riesgo significativos para el reflujo venoso en los pacientes con enfermedad leve. Palabras clave:. Insuficiencia sjgnificant.
Este topic es simplemente incomparable:) Me es interesante.