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The Israel Medical Association Journal... Dec 2022Data regarding risk factors for superficial thrombophlebitis (STP) cases presenting to a hospital is limited.
BACKGROUND
Data regarding risk factors for superficial thrombophlebitis (STP) cases presenting to a hospital is limited.
OBJECTIVES
To investigate and stratify clinical and laboratory risk factors for STP.
METHODS
We conducted a retrospective case control study comparing patients presenting to the emergency department with STP and age- and gender-matched controls. We collected data on multiple risk factors and five blood indices.
RESULTS
The study comprised 151 patients and matched controls. Patients with STP were more likely to have varicose veins (43.7% vs. 5.3%, P < 0.001), recent immobilization (14.6% vs. 1.3%, P < 0.001), obesity (36.4% vs. 18.5%, P = 0.001), a history of venous thromboembolism (VTE) or STP (27.2% vs. 0.7%, P < 0.001), and inherited thrombophilia (9.3% vs. 1.3%, P = 0.002). Following multivariate analysis, all five risk factors remained significant, with a history of VTE or STP associated with the largest risk (odds ratio [OR] 35.7), followed by immobilization (OR 22.3), varicose veins (OR 12.1), inherited thrombophilia (OR 6.1), and obesity (OR 2.7). Mean platelet volume was higher (8.5 vs 7.9 fl, P = 0.003) in STP cases.
CONCLUSIONS
A history of VTE or STP, immobilization, varicose veins, inherited thrombophilia, and obesity serve as independent clinical risk factors for STP presenting to hospital.
Topics: Humans; Retrospective Studies; Case-Control Studies; Venous Thromboembolism; Thrombophlebitis; Risk Factors; Varicose Veins; Obesity; Thrombophilia
PubMed: 36573782
DOI: No ID Found -
Frontiers in Immunology 2022In the broad range of human diseases, thrombo-inflammation appears as a clinical manifestation. Clinically, it is well characterized in context of superficial... (Review)
Review
In the broad range of human diseases, thrombo-inflammation appears as a clinical manifestation. Clinically, it is well characterized in context of superficial thrombophlebitis that is recognized as thrombosis and inflammation of superficial veins. However, it is more hazardous when developed in the microvasculature of injured/inflamed/infected tissues and organs. Several diseases like sepsis and ischemia-reperfusion can cause formation of microvascular thrombosis subsequently leading to thrombo-inflammation. Thrombo-inflammation can also occur in cases of antiphospholipid syndrome, preeclampsia, sickle cell disease, bacterial and viral infection. One of the major contributors to thrombo-inflammation is the loss of normal anti-thrombotic and anti-inflammatory potential of the endothelial cells of vasculature. This manifest itself in the form of dysregulation of the coagulation pathway and complement system, pathologic platelet activation, and increased recruitment of leukocyte within the microvasculature. The role of platelets in hemostasis and formation of thrombi under pathologic and non-pathologic conditions is well established. Platelets are anucleate cells known for their essential role in primary hemostasis and the coagulation pathway. In recent years, studies provide strong evidence for the critical involvement of platelets in inflammatory processes like acute ischemic stroke, and viral infections like Coronavirus disease 2019 (COVID-19). This has encouraged the researchers to investigate the contribution of platelets in the pathology of various thrombo-inflammatory diseases. The inhibition of platelet surface receptors or their intracellular signaling which mediate initial platelet activation and adhesion might prove to be suitable targets in thrombo-inflammatory disorders. Thus, the present review summarizes the concept and mechanism of platelet signaling and briefly discuss their role in sterile and non-sterile thrombo-inflammation, with the emphasis on role of platelets in COVID-19 induced thrombo-inflammation. The aim of this review is to summarize the recent developments in deciphering the role of the platelets in thrombo-inflammation and discuss their potential as pharmaceutical targets.
Topics: Humans; Female; Pregnancy; Endothelial Cells; Ischemic Stroke; COVID-19; Blood Platelets; Inflammation
PubMed: 36451834
DOI: 10.3389/fimmu.2022.1039843 -
Breast (Edinburgh, Scotland) Dec 2022Mondor's disease is a rare disorder characterised by thrombosis of superficial veins within the subcutaneous tissue of the breast and other organs. While factors such as...
BACKGROUND
Mondor's disease is a rare disorder characterised by thrombosis of superficial veins within the subcutaneous tissue of the breast and other organs. While factors such as trauma, infection, physical exertion, breast cancer and breast surgery have been implicated, in the majority no cause is identified.
PATIENTS
Twenty patients presented with a clinical diagnosis of Mondor's disease to the Edinburgh Breast Services in 2020. We present the etiopathogenic data as well as clinical and imaging diagnostic findings.
RESULTS
During 2020, the annual incidence of Mondor's disease, in the UK's largest breast unit, increased five-fold compared to data from the previous year. This variation in the frequency of cases corresponded to trends in the frequency of Covid-19 infection during the pandemic. None of the patients had diagnosed COVID and few had any known etiopathogenic causes for their Mondor's.
CONCLUSION
Several recent studies have provided evidence for links between Covid-19 and thromboembolic events. Isolated reports have proposed a link between Covid-19 and Mondor's disease of the penis. Here we present data on a large series of Mondor's disease of the breast supporting a link between breast Mondor's and Covid-19.
Topics: Male; Humans; Breast Neoplasms; COVID-19; Thrombophlebitis; Breast; Breast Diseases
PubMed: 36427369
DOI: 10.1016/j.breast.2022.11.006 -
Internal Medicine Journal Nov 2022Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years...
Cannula provoked upper extremity superficial vein thrombophlebitis (UESVT) is common. Retrospective audit of 93 consecutive patients, 51% male, median age 57 years (range 20-91), with symptomatic UESVT revealed varied management including symptomatic management (37%), prophylactic (37%) and higher dose anticoagulation (27%). There was 2% (95% confidence interval (CI) 0-7.6) thrombus extension and 1% (95% CI 0-5.9) major bleeding, both limited to cancer. We argue anticoagulation is unnecessary in most UESVT patients.
Topics: Male; Humans; Young Adult; Adult; Middle Aged; Aged; Aged, 80 and over; Female; Cannula; Retrospective Studies; Upper Extremity; Thrombophlebitis; Anticoagulants
PubMed: 36326238
DOI: 10.1111/imj.15951 -
Journal of Vascular Surgery Cases and... Dec 2022Cyanoacrylate glue closure (CAC) is being increasingly used as a minimally invasive procedure for the treatment of symptomatic incompetent saphenous veins. The most...
Cyanoacrylate glue closure (CAC) is being increasingly used as a minimally invasive procedure for the treatment of symptomatic incompetent saphenous veins. The most common adverse event associated with CAC has been phlebitis, including hypersensitivity phlebitis, superficial thrombophlebitis, and granulomatous phlebitis. This complication can be serious and debilitating. In the present report, we have described a case of symptomatic septicemia after CAC that required surgical excision of the treated saphenous veins.
PubMed: 36262917
DOI: 10.1016/j.jvscit.2022.09.008 -
International Journal of Medical... 2022RRx-001 is a small molecule NLRP3 inflammasome inhibitor with anti-CD47 and antiangiogenic/vascular normalization properties in a Phase 3 clinical trial that has been...
RRx-001 is a small molecule NLRP3 inflammasome inhibitor with anti-CD47 and antiangiogenic/vascular normalization properties in a Phase 3 clinical trial that has been designated as a drug-device combination by the FDA. In the Phase 1 first-in-man dose escalation clinical trial, where RRx-001 was given by direct intravenous (IV) infusion, the main adverse event was a sterile painful infusion phlebitis (IP). Less pain was experienced when RRx-001 was infused at a slower rate over multiple hours which was impractical on an outpatient basis. In Phase 2, for reasons of convenience and safety, RRx-001 was co-administered with an aliquot of autologous blood from an device called the eLOOP on the premise that RRx-001 binds to hemoglobin on red blood cells (RBCs), making it unavailable to directly interact with venous nociceptors. Phlebitis has the potential to progress to deep venous thrombosis or septic thrombophlebitis or post-thrombotic syndrome in hypercoagulable and immunosuppressed cancer patients. In this 13-week toxicology study of once weekly IV RRx-001 administration to Wistar Han rats followed by a recovery period of 28 days. The main observed toxicity was a significant inflammatory response in the vein wall, consistent with superficial venous thrombosis observed in man. Due to this development, direct IV infusion of RRx-001 is relatively contraindicated in favor of co-administration with autologous blood.
Topics: Animals; Azetidines; Hemoglobins; Inflammasomes; Inflammation; NLR Family, Pyrin Domain-Containing 3 Protein; Nitro Compounds; Phlebitis; Rats; Rats, Wistar
PubMed: 36237984
DOI: 10.7150/ijms.76615 -
Cureus Sep 2022Essential thrombocythemia (ET) is a myeloproliferative neoplasm involving the clonal proliferation of platelets. It is Philadelphia negative and is associated with...
Essential thrombocythemia (ET) is a myeloproliferative neoplasm involving the clonal proliferation of platelets. It is Philadelphia negative and is associated with Janus kinase 2 (JAK2), calreticulin (CALR), or myeloproliferative leukemia virus oncogene (MPL) mutations. The resultant platelets have quantitative and qualitative defects, making them more sticky and prone to thromboembolism. However, ET does not only affect platelet survival, it also has a low leukemogenic potential. It's more common in the elderly, 60 years or more, but can be seen in all age groups, including children. Patients with ET have an increased risk of vascular events like hemorrhage and thromboses like cerebrovascular events, myocardial infarction, superficial thrombophlebitis, deep vein thrombosis, and pulmonary embolism. Cardiovascular risk factors like hypertension, diabetes, and smoking can lead to increased thromboembolism and atherosclerosis. The management of ET focuses primarily on the prevention of thrombosis and hemorrhage. It involves cardiovascular risk management and antiplatelet and cytoreductive therapy according to the risk stratification. Low-risk ET patients are treated with low-dose aspirin, and high-risk ET patients are treated with cytoreductive therapy with hydroxyurea. Interferon (IFN) and anagrelide are reserved for young patients or pregnant women. This case report discusses a 40-year-old male, a known smoker presenting with myocardial infarction and left anterior descending artery (LAD) blockage without any prior history. His high platelets and the relative absence of cardiovascular risk factors helped reach the diagnosis, and bone marrow analysis and mutation analysis confirmed the diagnosis. The patient was started on hydroxyurea, which decreased the total platelet count.
PubMed: 36225436
DOI: 10.7759/cureus.28883 -
Case Reports in Plastic Surgery & Hand... 2022Mondor's disease (MD) is an uncommon clinical condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. In this...
Mondor's disease (MD) is an uncommon clinical condition characterized by thrombophlebitis of the superficial veins of the anterolateral thoracoabdominal wall. In this paper we present the first ever reported case of Mondor's disease in male patient after surgical correction of gynecomastia with liposuction assisted skin sparing adenectomy.
PubMed: 36147888
DOI: 10.1080/23320885.2022.2121711 -
BMC Veterinary Research Sep 2022Although the jugular vein is a major important blood vessel in equine, the literature lacks this vessel's normal B-mode and Doppler ultrasonographic examinations in...
BACKGROUND
Although the jugular vein is a major important blood vessel in equine, the literature lacks this vessel's normal B-mode and Doppler ultrasonographic examinations in donkeys. Therefore, this study aimed to determine the reference ranges of B-mode and Doppler ultrasonographic indices of jugular veins in healthy adult donkeys (Equus asinus) and the possible effect of examination side (left and right), gender, and body condition on the ultrasonographic measurements of this vessel. B-mode and Doppler ultrasound imaging of the external jugular vein was conducted on 20 adult healthy donkeys of both sexes.
RESULTS
In all donkeys, the jugular vein was 4.01 to 8.1 mm from the body surface. The longitudinal and transverse venous diameters ranged from 3.94 to 10.5 mm and from 0.88 to 1.9 cm, respectively. Moreover, the vein areas varied from 0.61 to 2.83 cm. The reference values of superficial and deep wall thickness (SWT and DWT) were 0.56 ± 0.2 and 0.6 ± 0.13 mm, respectively. The blood velocity, blood follow rate, and congestion index of the external jugular vein can be expected in adult healthy donkeys as a range value from 8.4 to 13.5 cm/sec, from 0.33 to 1.78 ml/min, and from 0.06 to 0.27 cm.sec, respectively. Generally, the vein showed laminar monophasic waveforms. The examination side and gender have no significant effect on the ultrasound measurements of the vein (P > 0.05). Donkeys with a body condition score (BCS) ≥ 3 revealed increases in the depth of the vein (P < 0.05).
CONCLUSIONS
The results of this study can be used as reference values and provide a basis for comparison when evaluating donkeys with diseases that affect blood flow in the external jugular vein.
Topics: Animals; Equidae; Female; Horses; Jugular Veins; Male; Ultrasonography; Ultrasonography, Doppler, Color
PubMed: 36104788
DOI: 10.1186/s12917-022-03441-y