International angiology : a journal of the International Union of Angiology
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Letters to the editor are brief texts that are published in a special section of medical journals. There are two types of letters to the editor: the observation and the comment. The former presents original work, while the latter constitutes criticism on work already published in the same journal. ⋯ Clarity and brevity should be their principal values. It is also important to comply with the journals' instructions for correspondence. Thus, eloquent letters to the editor may promote knowledge and enable fruitful exchange of ideas.
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Comparative Study
Trimetazidine and N-acetylcysteine in attenuating hind-limb ischemia and reperfusion injuries: experimental study in rats.
Lower-limb traumatic injury associated with ischemia and followed by reperfusion (I/R) is a common severe situation in muscle lesions due to trauma and hypoxia followed by local and systemic injuries induced by oxygen-derived free radical release during reperfusion. The aim of this study was to evaluate the attenuating effects of trimetazidine (TMZ) and N-acetylcysteine (NAC) in such situation. ⋯ This experimental model simulated severe limb trauma associated with ischemia and reperfusion, and, as such, it was aggressive, causing severe injury and local inflammatory reaction. The model did not show antioxidant action from NAC, and possible antioxidant action from TMZ was insufficient to attenuate tissue injuries.
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The aim of this paper was to evaluate the efficacy of the concomitant use of endovenous laser treatment (ELT) and ultrasound-guided foam sclerotherapy (USGFS) in the management of chronic venous disorder and to objectively analyze the influence of the combination therapy on the Health Related Quality of Life (HRQL) of the treated patients. ⋯ Ultrasound-guided foam sclerotherapy given concomitantly with ELT is safe and highly efficacious in the management of GSV, SSV reflux and in their tributaries or in non-saphenous veins. CVD patients treated with combination therapy given in this manner demonstrated significant improvement in their HRQL.
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The value of TCD in clinical practice is well established since it can be used to measure cerebral vasomotor reactivity and to detect and grade vasospasm (VSP) following subarachnoid haemorrhage and cerebral blood perfusion consequences of extracranial ICA stenosis or occlusion. Intracranial steno-occlusive disease can be detected more reliably by transcranial color-coded imaging (TCCI) that provides a two-dimensional imaging of parenchymal and vascular anatomy of brain too. In patients with suspected brain TCD diagnostic criteria for brain death have a sensitivity of 91 to 100% and specificity of 97 to 100% and they are particularly useful when clinical and EEG evaluations are difficult. ⋯ Furthermore DWI has shown a higher prevalence of postoperative small areas of brain ischemia due to asymptomatic embolism occurring during CAS than after carotid surgery according with a higher incidence of patients suffering from neuropsychological impairment after CAS as compared with those submitted to CEA. The use of TCD can provide new insights into pathophysiology of cerebral steno-occlusive and functional diseases, it can helps in risk stratifications of patients with cardio-embolic sources and in the choice and monitoring of medical, surgical or endovascular treatment. TCD monitoring during carotid revascularization either surgical or endovascular can alert the operator to take appropriate measures to avoid brain ischemia and provides useful data for choice and control of the different brain protection devices.