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Şirin G, Karaveli Cakir S, Eryiğit S, Toz H, Pirhan O, Erpolat Taşabat S, Çalişkan İ. Photoplethysmography-based assessment of varicose vein-related risk factors, exercise health beliefs, and venous refill time in healthcare professionals working in operating rooms and outpatient clinics. Phlebology 2024:2683555241258308. [PMID: 38887802 DOI: 10.1177/02683555241258308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACGROUND Impaired venous return is observed in healthcare professionals who spend long periods standing and sitting. This descriptive cross-sectional study was conducted to evaluate varicose vein-related risk factors, exercise health beliefs, and venous refill time in healthcare professionals working in operating rooms and outpatient clinics by photoplethysmography. METHOD The study sample consisted of 100 healthcare professionals without a diagnosis of peripheral venous insufficiency. Data were collected using a descriptive characteristics form, the Health Belief Model Scale for Exercise, the Short-Form McGill Pain Questionnaire, and photoplethysmography. RESULT This study found that OR nurses had shorter venous refill times and experienced more pain due to prolonged standing, despite their high health beliefs about exercise. CONCLUSION Healthcare professionals working in operating rooms should be screened for venous insufficiency and trained regarding the practices to prevent venous insufficiency, such as lying down, elevating legs, and using elastic stockings.
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Affiliation(s)
- Gökçe Şirin
- Medicana Hospital, Cardiovascular Surgeon, İstanbul, Türkiye
| | - Selda Karaveli Cakir
- Health Sciences Faculty, Nursing Department, Kastamonu University, Kastamonu, Türkiye
| | - Sinem Eryiğit
- Acıbadem Bakırköy Hospital Cardiovascular Intensive Care Unit, Nurse, İstanbul, Türkiye
| | - Hasan Toz
- Cardiovascular Surgeon, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | - Osman Pirhan
- Cardiovascular Surgeon, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
| | | | - İlknur Çalişkan
- Nursing Department, İzmir Tınaztepe University, İzmir, Türkiye
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Nadasy GL, Patai BB, Molnar AA, Hetthessy JR, Tokes AM, Varady Z, Dornyei G. Vicious Circle With Venous Hypertension, Irregular Flow, Pathological Venous Wall Remodeling, and Valve Destruction in Chronic Venous Disease: A Review. Angiology 2024:33197241256680. [PMID: 38839285 DOI: 10.1177/00033197241256680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Substantial advances occurred in phlebological practice in the last two decades. With the use of modern diagnostic equipment, the patients' venous hemodynamics can be examined in detail in everyday practice. Application of venous segments for arterial bypasses motivated studies on the effect of hemodynamic load on the venous wall. New animal models have been developed to study hemodynamic effects on the venous system. In vivo and in vitro studies revealed cellular phase transitions of venous endothelial, smooth muscle, and fibroblastic cells and changes in connective tissue composition, under hemodynamic load and at different locations of the chronically diseased venous system. This review is an attempt to integrate our knowledge from epidemiology, paleoanthropology and anthropology, clinical and experimental hemodynamic studies, histology, cell physiology, cell pathology, and molecular biology on the complex pathomechanism of this frequent disease. Our conclusion is that the disease is initiated by limited genetic adaptation of mankind not to bipedalism but to bipedalism in the unmoving standing or sitting position. In the course of the disease several pathologic vicious circles emerge, sustained venous hypertension inducing cellular phase transitions, chronic wall inflammation, apoptosis of cells, pathologic dilation, and valvular damage which, in turn, further aggravate the venous hypertension.
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Affiliation(s)
- Gyorgy L Nadasy
- Department of Physiology, Semmelweis University, Budapest, Hungary
| | | | - Andrea A Molnar
- Department of Cardiology, Semmelweis University, Budapest, Hungary
| | | | - Anna-Maria Tokes
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Budapest, Hungary
| | | | - Gabriella Dornyei
- Department of Morphology and Physiology, Health Science Faculty, Semmelweis University, Budapest, Hungary
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3
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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4
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Xiang Y, Zhou Q, Wu Z, Gou J. Chronic Venous Insufficiency in A Selected Nurse Population: A Cross-Sectional Study. Angiology 2024; 75:29-35. [PMID: 36172846 DOI: 10.1177/00033197221130571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic venous insufficiency (CVI) causes severe symptoms and complications in the general population, but the prevalence, related risk factors, and treatment of CVI are unknown among nurses. The demographics and occupational factors of nurses from a university hospital were collected by questionnaires, and the presentation of CVI was confirmed by the specialist vascular surgeons. A total of 1606 participants were enrolled, and the prevalence of CVI was 7.5%. After multivariate adjustment, CVI was positively related to deep venous thrombosis history (OR 6.44, 95% CI 2.73-15.22), increased standing time (OR 2.21, 95% CI 1.20-4.10), and increased time in night shift rotation (OR 2.01, 95% CI 1.29-3.14). CVI was negatively related to oral contraceptives (OR .43, 95% CI .21-.87). Of the participants, 72.5% with CVI received compression therapy. For them, wearing compression stockings with a pressure of >20 mmHg or for >4 h/day significantly increased the rate of symptom relief, while the length of compression stockings made no difference. Thus, it was beneficial for nurses to spend less time standing and shorten their time in night shift rotation. Wearing compression stockings with sufficient pressure and for enough time was recommended for CVI symptom relief.
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Affiliation(s)
- Yuwei Xiang
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qian Zhou
- Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhoupeng Wu
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Juxiang Gou
- Department of Thyroid & Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
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Benn S, Moore Z, Patton D, O'Connor T, Nugent L, Harkin D, Avsar P. What is the prevalence of chronic venous disease among health care workers? A scoping review. Int Wound J 2023; 20:3821-3839. [PMID: 37139850 PMCID: PMC10588334 DOI: 10.1111/iwj.14222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/21/2023] [Indexed: 05/05/2023] Open
Abstract
Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of existing publications exploring the prevalence of CVD among health care workers was conducted in July 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. A total of 15 papers met the inclusion criteria and these formed the basis of the review. Among health care workers, the mean prevalence of CVD was 58.5% and the mean prevalence for varicose veins was 22.1%. There is an increased prevalence of CVD in health care workers when compared with the general population. Therefore, there is a need for early diagnosis and the use of preventative measures to protect health care workers from CVD and varicose vein development.
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Affiliation(s)
- Sarah Benn
- School of Medicine, Royal College of Surgeons in IrelandUniversity of Medicine and Health SciencesDublinIreland
| | - Zena Moore
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQueenslandAustralia
- Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneVictoriaAustralia
- Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium
- Lida InstituteShanghaiChina
- University of WalesCardiffUK
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound CareMenzies Health Institute QueenslandGriffithQueenslandAustralia
| | - Declan Patton
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQueenslandAustralia
- Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
| | - Tom O'Connor
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQueenslandAustralia
| | - Linda Nugent
- Fakeeh College of Health SciencesJeddahSaudi Arabia
- School of Nursing and MidwiferyThe Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
| | - Denis Harkin
- Department of Medical Professionalism, Faculty of Medicine and Health SciencesRCSI University of Medicine and Health SciencesDublinIreland
| | - Pinar Avsar
- Skin Wounds and Trauma Research Centre. The Royal College of Surgeons in Ireland (RCSI)University of Medicine and Health SciencesDublinIreland
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Babaei M, Afrooghe A, Rafati A, Mohebbi B, Moosavi J, Ghadri N, Koohestani BM, Rahimi S, Baay M, Alemzadeh-Ansari MJ, Hosseini Z, Boudagh S, Khalilipur E, Ghaemmaghami Z, Pasebani Y, Firoozbakhsh P, Pouraliakbar H, Bakhshandeh H, Sadeghipour P. Prevalence and associated factors of chronic venous disease among the modern Iranian urban population. J Vasc Surg Venous Lymphat Disord 2023; 11:1098-1106.e10. [PMID: 37690625 DOI: 10.1016/j.jvsv.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/17/2023] [Accepted: 06/08/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Chronic venous disease (CVD) of the lower extremities is one of the common venous diseases in different populations, with a wide range of clinical manifestations and undetermined exact prevalence owing to different population characteristics and measurement methods. This study aimed to estimate the prevalence of CVD among the modern Iranian urban population and determine its associated risk factors. METHODS The Heart Assessment and Monitoring in Rajaie Hospital study, a longitudinal population-based cohort, aims to investigate the baseline prevalence and the 10-year incidence of cardiovascular diseases and associated risk factors in the adult population aged 30 to 75 years with no overt cardiovascular diseases in Tehran. Two instructed interventional cardiologists performed CVD evaluation using the Clinical-Etiology-Anatomy-Pathophysiology classification. CVD was graded as C1 to C6, and chronic venous insufficiency (CVI) as C3 to C6. A multivariable regression model was used to analyze the association between CVD and prespecified covariates of age, sex, body mass index (≥30 kg/m2), smoking, hypertension, diabetes mellitus, physical activity, dyslipidemia, and delivery method. RESULTS CVD prevalence among 1176 participants was 36.5% (95% confidence interval [CI], 33.8-39.3) and was higher in women than men (44.2% vs 23.5%). CVI prevalence was only 0.7% (95% CI, 0.3-1.3). Multivariable analysis showed that advanced age (odds ratio [OR], 1.06; 95% CI, 1.04-1.08), female sex (OR, 2.98; 95% CI, 2.14-4.14), and body mass index of ≥30 (OR, 1.36; 95% CI, 1.03-1.81) were independently associated with CVD. Physical activity (OR, 0.77; 95% CI, 0.58-1.02) was nearly protective, whereas other factors, including traditional cardiovascular risk factors, had no meaningful association with CVD. CONCLUSIONS Our findings showed that CVD was prevalent in the modern Iranian urban population. However, considering the very low prevalence of the higher stages of the disease, the benefit of mass screening is debatable, and better risk discriminators should be investigated.
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Affiliation(s)
- Mohammadreza Babaei
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arya Afrooghe
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rafati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jamal Moosavi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Narges Ghadri
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Mohajer Koohestani
- Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shahin Rahimi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Baay
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Boudagh
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Khalilipur
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghaemmaghami
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yeganeh Pasebani
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parisa Firoozbakhsh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Yaghi M, Hargis A, Maskan Bermudez N, Chopra D, Lev-Tov H. Prevalence of venous dermatitis: results of a regional cohort study of patients with confirmed chronic venous insufficiency. Int J Dermatol 2023; 62:e550-e551. [PMID: 37391894 DOI: 10.1111/ijd.16750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 05/31/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Marita Yaghi
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Abby Hargis
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Narges Maskan Bermudez
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Divya Chopra
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hadar Lev-Tov
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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8
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Mayrovitz HN, Aoki KC, Colon J. Chronic Venous Insufficiency With Emphasis on the Geriatric Population. Cureus 2023; 15:e40687. [PMID: 37485203 PMCID: PMC10358300 DOI: 10.7759/cureus.40687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
The underpinning of Chronic Venous Insufficiency (CVI) is valvular dysfunction, which manifests on a spectrum depending on the severity of insufficiency and duration of the disease. The mainstay of treatment relies on compression therapy of a proper type and intensity. In older adults, special consideration must be taken during the patient encounter to account for age-related factors. This review discusses the clinical presentation, diagnosis, and mimicking of CVI, focusing mainly on older adults. The epidemiology, risk factors, disease burden, and grave complications -- such as thrombosis and ulceration, are reviewed. The physiological impacts of CVI are described, providing the background for treatment strategies, including non-invasive, medical, and surgical therapies. The findings show advanced age to be an important risk factor contributing to CVI and that other age-related factors add to the risk of severe complications. Clinical assessments combined with objective measurements that assess localized skin water using tissue dielectric constant values or whole limb assessments may aid in the differential diagnosis. Furthermore, understanding the mechanism of action of compression therapy, the mainstay of CVI treatment, and its physiological impacts, allows for its informed use in geriatric patients with increased risks of potential compression-related side effects.
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Affiliation(s)
- Harvey N Mayrovitz
- Medical Education and Simulation, Nova Southeastern University's Dr. Kiran C. Patel College of Allopathic Medicine, Davie, USA
| | - Kawaiola C Aoki
- Medicine, Nova Southeastern University's Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Jessica Colon
- Medicine, Nova Southeastern University's Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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9
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1076] [Impact Index Per Article: 1076.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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10
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Mansilha A, Caldevilla H, Puskás A, Lucien A, Roby L, Kirienko A. MPFF 1000 mg chewable once daily vs. MPFF 500 mg twice daily in chronic venous disease: the double-blind, randomized, non-inferiority CHEWY trial. INT ANGIOL 2022; 41:464-475. [PMID: 36598370 DOI: 10.23736/s0392-9590.22.04987-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The efficacy and tolerability of the new micronized purified flavonoid fraction (MPFF) 1000 mg once-daily chewable formulation in comparison with the established MPFF 500 mg conventional tablet at the same daily dose are unknown. METHODS CHEWY was an international, multicenter, double-blind, double-dummy, randomized, parallel group, non-inferiority phase III study conducted in adult patients with symptomatic chronic venous disease (CVD). Patients were randomly allocated to MPFF 1000 mg chewable or MPFF 2x500 mg daily treatment. The primary efficacy endpoint for clinical non-inferiority (non-inferiority margin predefined at 1 cm) was lower limb discomfort (LLD) assessed by a 10 cm electronic visual analog scale (eVAS) at 8 weeks. Secondary endpoints included leg pain (LP), leg heaviness (LH), and quality of life (QoL) measured by the eCIVIQ-14 questionnaire. Overall acceptability was assessed at each visit by patient and investigator. RESULTS Three hundred and nine patients were randomized to MPFF 1000 mg chewable and 302 to MPFF 2x500 mg. After 8 weeks, LLD decreased from baseline by -3.6±2.4 cm and -3.6±2.5 cm in the MPFF chewable and 2x500 mg groups, respectively. Non-inferiority of the once-daily chewable formulation compared with twice daily tablets on improving LLD was demonstrated (adjusted between-group difference [Standard Error]) (E [SE]) = 0.00 (0.18) cm, 95%CI -0.35; 0.35, non-inferiority P value <0.0001. Decreases of similar magnitude were observed at 8 weeks for LP and LH in both treatment arms: -3.4±2.3 cm and -3.5±2.5 cm, respectively for LP, and -3.5±2.5 cm and -3.5±2.6 cm, respectively for LH. QoL (global score) improved by -21.0±17.2 and -22.5±20.1 in the MPFF 1000 mg chewable group and 2x500 mg groups, respectively (E [SE]=1.03 [1.20], 95%CI [-1.32; 3.38]), with similar improvements in the QoL subscore components in both groups. Treatment acceptability was high for both patients and physicians and tolerability similar to the tablet formulation. CONCLUSIONS MPFF 1000 mg chewable was non-inferior to MPFF 2x500 mg tablets with respect to its effect on LLD. Both formulations were associated with improvements of similar magnitude in lower limb symptoms and QoL. The chewable formulation was observed to be well tolerated and well accepted. Once-daily MPFF chewable tablet offers patients with CVD a good alternative treatment regimen.
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Affiliation(s)
| | - Hector Caldevilla
- Argentine College of Venous & Lymphatic Surgery, Buenos Aires, Argentina
| | - Attila Puskás
- Angio-Center-Vascular Medicine, Targu Mures, Romania
| | - Arnaud Lucien
- Servier Institute of International Research, Suresnes, France -
| | - Lucas Roby
- Servier Institute of International Research, Suresnes, France
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11
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Kim DS, Won YH, Ko MH. Comparison of intermittent pneumatic compression device and compression stockings for workers with leg edema and pain after prolonged standing: a prospective crossover clinical trial. BMC Musculoskelet Disord 2022; 23:1007. [PMID: 36419142 PMCID: PMC9685841 DOI: 10.1186/s12891-022-05975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/12/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND During prolonged standing, insufficient calf muscle pumping accompanies venous stasis and hypertension in the lower legs, resulting in valve dysfunction, venous wall problems, and sub-sequent inflammation. Compression therapy, which includes medical compression stockings (MCS) and mechanical intermittent pneumatic compression (IPC), is one of the most effective therapeutic interventions for treating chronic venous diseases. This study aimed to compare the therapeutic effect among resting, IPC and MCS alone, and IPC with MCS in long-standing workers (> 8 h daily). METHODS This crossover trial was conducted with 39 participants with complaints of leg edema and pain whose work involved standing for more than 8 h daily. Four treatment protocols were established for each visit as follows: protocol A (not wear MCS during work and rest without IPC after work), protocol B (wear MCS during work and rest without IPC after work), protocol C (not wear MCS during work and treat with IPC after work), and protocol D (wear MCS during work and treat with IPC after work). The primary outcome was the visual analogue scale (VAS) score for leg pain. The secondary outcomes were leg volume (mL), circumference (cm), extracellular fluid/total body fluid (ECF/TBF), and extracellular water/total body water (ECW/TBW) through bioelectrical impedance analysis. Outcomes were assessed before work (T0), after work (T1), and 60 min after intervention (T2). RESULTS All four protocols had significantly increased leg pain after work (T0-1) but improved 60 min after intervention (T1-2), particularly protocol C (decreased VAS by 1.9). When leg swelling was compared at T0 and T1, protocols A and C showed significant increases in leg volume and circumference, indicating significant work-induced edema, whereas protocols B and D showed no change or even a decrease. After interventions, leg volume and circumference significantly decreased in protocols A and C, although protocols B and C did not show significant improvement. The ECF/TBF and ECW/TBW of all protocols decreased after interventions. CONCLUSIONS Leg pain and edema after prolonged standing (T1-T2) in adults were safely and effectively improved by both IPC alone and IPC with MCS. Although the use of MCS during the workday did not show improvement in leg pain immediately after work (T0-T1), both MCS with resting and MCS with IPC decreased leg pain at T1-T2 and prevented leg edema at T0-T1. TRIAL REGISTRATION This trial protocol was registered at the Clinical Research Information Service (KCT0005383, the date of first registration: 08/09/2020).
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Affiliation(s)
- Da-Sol Kim
- grid.411545.00000 0004 0470 4320Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea ,grid.411545.00000 0004 0470 4320Research Institute of Clinical Medicine, Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Yu Hui Won
- grid.411545.00000 0004 0470 4320Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea ,grid.411545.00000 0004 0470 4320Research Institute of Clinical Medicine, Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Myoung-Hwan Ko
- grid.411545.00000 0004 0470 4320Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea ,grid.411545.00000 0004 0470 4320Research Institute of Clinical Medicine, Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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12
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Rusinovich Y, Rusinovich V. Earth’s gravity field and prevalence of varicose veins and chronic venous disease: Systematic review. Phlebology 2022; 37:486-495. [DOI: 10.1177/02683555221090054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim This study examines the influence of Earth’s gravity field on the prevalence of varicose veins in geophysical area. Material and Methods We performed a systematic review (OVID and Google Scholar) of studies focusing on prevalence of varicose veins to determine the influence of Earth’s gravity field—GRACE GGM05S gravity model—on the disease prevalence. PROSPERO: CRD42021279513. Results 81 studies met inclusion and quality criteria. Areas with stronger gravity have significantly higher prevalence of varicose veins with adjustment for age, gender and body mass index (BMI) ( p-values < 0.02). Adjusted for age, prevalence of varicose veins in areas with gravity field +20 mGal and more is 1.37 time higher than in areas with gravity field less than +20 mGal, p-value 0.005 (95% CI: −12.5 to −2.4): mean disease prevalence for gravity field +20 mGal and more—27.5% (mean age, 40.1 years; mean gravity field, +27.1 mGal; 63.9% females, 37 studies, 123,164 participants) vs mean disease prevalence for gravity field less than +20 mGal – 20.1% (mean age, 42.2 years; mean gravity field, +5.7 mGal; 56.8% females, 44 studies, 205,925 participants). Older age is the main risk factor for varicose veins ( p-values < 0.005). Female gender and high BMI are insignificantly associated with high prevalence of varicose veins ( p-values > 0.4 for gender, p-values > 0.2 for BMI). Conclusion Stronger gravity field is significantly associated with higher prevalence of varicose veins—risk factor. The potential mechanism of this phenomenon is that high gravity field alters systemic venous return, pooling blood and fluid in the peripheral, gravity-dependent regions of the body in upright humans constantly living in the defined geophysical area.
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Affiliation(s)
- Yury Rusinovich
- Department of Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Volha Rusinovich
- Institute of Hygiene and Environmental Medicine, University Hospital Leipzig, Leipzig, Germany
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13
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Azar J, Rao A, Oropallo A. Chronic venous insufficiency: a comprehensive review of management. J Wound Care 2022; 31:510-519. [PMID: 35678787 DOI: 10.12968/jowc.2022.31.6.510] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic venous insufficiency is an extensive progressive disease in need of public health attention. This insidious disease is a growing burden on patient quality of life and the health economy. Chronic venous insufficiency has become more pronounced in global populations, especially in regions exhibiting a higher rate of risk factors. It is critical for healthcare providers to recognise and intervene early to prevent ongoing and debilitating complications. This article provides a comprehensive review of chronic venous insufficiency outlining the anatomy, pathophysiology, clinical presentation, assessment and management options.
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Affiliation(s)
- Julian Azar
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, US
| | - Amit Rao
- Comprehensive Wound Healing & Hyperbarics Center, Northwell Health, Lake Success, NY US
| | - Alisha Oropallo
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, US.,Comprehensive Wound Healing & Hyperbarics Center, Northwell Health, Lake Success, NY US
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14
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2300] [Impact Index Per Article: 1150.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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15
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Alnaser AR, Khojah AAA, Hashemi ASA, Alsabban B, Musa AYE, Albasheer EA, Rajab TM, Ali MA, Saquib J, Almazrou A, Saquib N. Knowledge of and attitude toward venous thromboembolism among professional drivers in Saudi Arabia. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:396-402. [PMID: 33829954 DOI: 10.1080/19338244.2021.1910118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Evidence suggests that professional drivers are at risk for venous thromboembolism (VTE), a life-threatening yet preventable disease. Awareness of VTE among this population has not been assessed in the Middle East. The study aimed to assess professional drivers' awareness of VTE and attitudes toward VTE preventive measures. We used a validated VTE awareness questionnaire to interview 324 drivers in Saudi Arabia during February-March 2020. Knowledge about VTE was the lowest compared to other medical conditions. Less than a third (31.8%) of the drivers were aware of VTE. Only 15.7% of those with prior awareness correctly identified all four deep vein thrombosis symptoms, and only 7.4% correctly identified all five pulmonary embolism symptoms. A significant proportion believed in unrelated practices for VTE prevention. Health promotion campaigns are urgently needed to raise awareness and to promote healthy behaviors.
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Affiliation(s)
- Adnan Raed Alnaser
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | | | - Ammar S A Hashemi
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Bandar Alsabban
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Ammar Y E Musa
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Eltayeb A Albasheer
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Tawfik Mamoun Rajab
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Mohamed A Ali
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Juliann Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Abdulrahman Almazrou
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi University, Al Bukayriah, Al-Qassim, Saudi Arabia
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16
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Kim Y, Png CYM, Sumpio BJ, DeCarlo CS, Dua A. Defining the human and health care costs of chronic venous insufficiency. Semin Vasc Surg 2021; 34:59-64. [PMID: 33757637 DOI: 10.1053/j.semvascsurg.2021.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Chronic venous insufficiency (CVI) affects more than 25 million adults in the United States alone, and more 6 million with advanced stages of venous disease. The high incidence of CVI and the increasing costs of care, place a heavy financial burden on the US health care system. Recent studies estimate the total cost of care at more than $3 billion per year. These staggering numbers highlight the importance of timely diagnosis, treatment, and prevention of CVI. In this article, we review the epidemiology and prevalence of CVI, and its financial impact on national health care budget. Racial disparities in CVI and the impact of socioeconomic status on access to care are also discussed. Finally, we discuss CVI-related screening programs and the importance of preventative measures in venous disease.
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Affiliation(s)
- Young Kim
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Wang 440, Boston, MA 02114
| | - C Y Maximilian Png
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Wang 440, Boston, MA 02114
| | - Brandon J Sumpio
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Wang 440, Boston, MA 02114
| | - Charles S DeCarlo
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Wang 440, Boston, MA 02114
| | - Anahita Dua
- Division of Vascular and Endovascular Surgery, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Wang 440, Boston, MA 02114.
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17
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Affiliation(s)
- Su-kyung Kwon
- Division of Vascular and Endovascular Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hyangkyoung Kim
- Division of Vascular Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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