Endovenous treatment for varicose veins of the lower limbs: Comparative histological evaluation of different techniques.

Background: In recent years, tumescent ablative techniques have been joined by non-tumescent ablative techniques. The aim of the research is to study and compare the effects produced by the different endovascular ablative techniques, from the histological point of view, at the level of the venous wall (endothelium, tunica media and adventitia).

Method: The study involves the use of three ablative endovascular techniques (EVLA, MOCA, CGO) on bench for the treatment of the great saphenous vein.

Segmental differences in daytime changes of leg volume.

Background: The aim of our study was to comparatively assess volume changes related to daily occupation of the whole leg (WLv), of the lower leg (LLv) and of the upper leg (ULv) in subject with no venous and lymphatic disorders.

Method: WLv, LLv, and Ulv were evaluated by water displacement volumetry (WDV) in the morning and in the evening in 20 healthy subjects.

Results: In the legs with occupational edema (OE), WLv increased by 7.

The anterior saphenous vein. Part 3. Systematic review of the literature and payor coverage policies. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology.

Objective: The objective of this study is to systemically review the literature on Anterior Saphenous Vein (ASV) reflux treatment and insurance impediments to treatment coverage.

Methods: A literature search was performed using a PRISMA framework. In addition, a cross-sectional analysis of insurance policies for ASV treatment was evaluated.

The anterior saphenous vein. Part 2. Anatomic considerations in normal and refluxing patients. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology.

Background: The term Anterior Accessory of the Great Saphenous Vein suggests this is a branch tributary vein despite this vessel's anatomic features of a truncal vein. A multisocietal group suggested to designate this the anterior saphenous vein (ASV). This study was aimed to evaluate its ultrasound anatomy in normal and varicose limbs.

The anterior saphenous vein. Part 4. Clinical and technical considerations in treatment. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology.

Background: The decision to treat a refluxing anterior saphenous vein (ASV) should be a clinical decision based on the assessment on the ASV's contribution to patient's signs and symptoms. Once the decision to treat has been made, there are anatomic, clinical, and technical considerations in treatment planning.

Methods: Clinical scenarios were discussed by a panel of experts and common anatomic, clinical, and technical considerations were identified.

The anterior saphenous vein. Part 3. Systematic review of the literature and payor coverage policies. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum and the International Union of Phlebology.

Objective: The objective of this study is to systemically review the literature on Anterior Saphenous Vein (ASV) reflux treatment and insurance impediments to treatment coverage.

Methods: A literature search was performed using a PRISMA framework. In addition, a cross-sectional analysis of insurance policies for ASV treatment was evaluated.

The Anterior Saphenous Vein. Part 2. Anatomic considerations in normal and refluxing patients. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum and the International Union of Phlebology.

Background: The term Anterior Accessory of the Great Saphenous Vein suggest this is a branch tributary vein despite this vessel's anatomic features of a truncal vein. A multisocietal group suggested to designate this the Anterior Saphenous Vein (ASV). This study was aimed to evaluate its ultrasound anatomy in normal and varicose limbs.

The anterior saphenous vein. Part 1. A position statement endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology.

Background: There is a lack of clarity regarding the terminology of the anterior accessory saphenous vein (AASV) that can impact treatment outcomes. Although use of the word "accessory" implies that the vein is a superficial tributary, evidence supports its role as a truncal vein, similar to the great and small saphenous veins, and warranting a change in terminology.

Methods: A multisocietal panel was convened by the American Vein and Lymphatic Society (AVLS), the Union International of Phlebology (UIP), and the American Venous Forum (AVF).

Black holes in compression therapy: A quest for data.

Objective: Although compression therapy (CT) is considered a crucial conservative treatment in chronic venous disease, strong evidence is missing for many clinical indications. This literature review aims to point out what strong evidence we have for CT and all the clinical scenarios where strong evidence still needs to be included.

Methods: The research was conducted on MEDLINE with PubMed, Scopus and Web of Science.

The anterior saphenous vein. Part 1. A position statement endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology.

Background: There is a lack of clarity regarding the terminology of the anterior accessory saphenous vein (AASV) that can impact treatment outcomes. Although use of the word "accessory" implies that the vein is a superficial tributary, evidence supports its role as a truncal vein, similar to the great and small saphenous veins, and warranting a change in terminology.

Methods: A multisocietal panel was convened by the American Vein and Lymphatic Society (AVLS), the Union International of Phlebology (UIP), and the American Venous Forum (AVF).

Ultrasonographic study of the effects of compressive stockings on legs with venous edema.

Objectives: The occurrence of leg edema in patients with chronic venous disease (CVD) is currently evaluated by visual inspection, palpation, and measurement of limb circumference. The changes of soft tissues morphology in swollen legs have been poorly investigated by ultrasonography (US) in the past. The purpose of this study was to evaluate the effects of medical compression stockings (MCS) on the US morphology of the cutaneous and subcutaneous layers (CL and SCL, respectively) in legs with venous edema.

A Regional Survey on Merkel Cell Carcinoma: A Plea for Uniform Patient Journey Modeling and Diagnostic-Therapeutic Pathway.

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine cancer that usually affects the elderly and immunosuppressed in sun-exposed areas. Due to its rarity, it is frequently unrecognized, and its management is not standardized across medical centers, despite the more recent availability of immunotherapy, with avelumab as first-line treatment improving the prognosis even in advanced stages of disease. We conducted a purpose-designed survey of a selected sample of physicians working in the Lazio region, in Italy, to assess their awareness and knowledge of MCC as well as their perspective on assisted diagnostic and therapeutic pathways.

Rationale and current evidence of aquatic exercise therapy in venous disease: A narrative review.

Chronic venous disorders (CVD) of the lower limbs can be treated with different strategies. Typically, conservative management is based on compression therapy, anticoagulants and venoactive drugs. Endovenous treatments remain the gold standard to treat saphenous insufficiency, with sclerotherapy and surgery maintaining a role in selected cases.

Subcutaneous calcifications in legs with chronic venous diseases.

Background: Calcifications in the subcutaneous layer (SCL) have been described by radiographic studies of legs with advanced chronic venous disease (CVD). However, SCL calcifications have rarely been included among the CVD-related changes. The aim of the present study was to evaluate the prevalence and morphology of SCL calcifications in legs with CVD of all grades of severity determined by ultrasound.

The effects of water immersion and walking on leg volume, ankle circumference and epifascial thickness in healthy subjects with occupational edema.

Background: Balneotherapy has been considered beneficial in patients with chronic venous disease due to patient-reported positive outcomes on improvement of symptoms and quality of life.Study aim: Assessing the effects of prolonged water immersion (WI) on leg edema and epifascial thickness and to compare these data with those achieved after continuous walking on ground.

Material And Methods: On three consecutive days, 14 otherwise healthy volunteers (9 females, 5 males, mean age 53 ± 10 years) affected by occupational edema (OE), defined as the edema developing during the time period of the working day and disappearing overnight, stayed standing immobile in a swimming pool for 30 minutes (30'), continuously walking again for 30' in the same pool and walking on ground for 30' without interruptions in a randomized sequence.

[The integrated care pathway for non melanoma skin cancer: the Istituto Dermopatico dell'Immacolata - IRCCS experience in Rome.].

The incidence of non-melanoma skin cancers (NMSC) is increasing worldwide and these skin cancers have become an important health issue. An integrated care pathway (ICP) is a multidisciplinary outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition. The aim of this paper is to define the ICP for patients affected by NMSC referring to the Istituto Dermopatico dell'Immacolata - IRCCS of Rome and Villa Paola, Italy.

The Feasibility of Underwater Computerised Strain Gauge Plethysmography and the Effects of Hydrostatic Pressure on the Leg Venous Haemodynamics.

Background: Strain gauge plethysmography (SGP) is employed to evaluate venous drainage of the lower leg.

Methods: In this study, SGP was used to evaluate the effects of the hydrostatic pressure (HP) of water on venous volume (VV), expelled volume, and ejection fraction (EF) in 22 healthy legs before and during immersion in water.

Results: HP reduced VV by 100% and even more during underwater (UW) exercise, making calculation of the UW EF possible.

Intralesional ultrasound-guided combined treatment with triamcinolone plus lincomycin in hidradenitis suppurativa: A pilot study.

Hidradenitis suppurativa (HS) is a chronic, inflammatory, disease of the hair follicle. Intralesional corticosteroid treatment in HS patients has been reported, and while several data described this route of administration as an efficient delivery system, its efficacy is still debated. The aim of this study was to explore the clinical efficacy and the effect on quality of life (QoL) of an innovative intralesional treatment in HS patients.

High level of TILs is an independent predictor of negative sentinel lymph node in women but not in men.

Factors that are most associated with positive lymph node status in melanoma are Breslow thickness and ulceration. However, there are other factors that have been little explored and could help in the identification of "at risk patients" harbouring occult metastasis. The objective of this study was to determine whether intensity of tumour-infiltrating lymphocytes (TILs) in a cohort study (N = 4133) is an independent predictor of sentinel lymph node (SLN) status in patients with primary cutaneous melanoma.

Venous intima-media thickness increases both in deep and superficial systems in patients with great saphenous vein reflux.

Objective: To evaluate by Doppler ultrasound (DUS) the venous intima-media thickness (vIMT) in patients with or without great saphenous vein (GSV) incompetence.

Methods: A prospective vIMT measurement was performed by DUS in an outpatient cohort. Patients were divided in two groups: group A, patients without GSV reflux; and group B, patients with at least one refluxing GSV.

Ultrasound of verrucous hyperplasia of the skin related to venous stasis and effects of compression treatment.

Verrucous hyperplasia of the skin rarely occurs in legs with severe venous stasis. In these cases, ultrasound demonstrated thickening and hyperechogenicity of the skin layers. The core of the verrucous-like protrusions consisted of a fibrous lump of the reticular dermis, surrounded by an anechogenic layer and covered by a thickened epidermal shell.

The Broad-Spectrum Impact of Hidradenitis Suppurativa on Quality of Life: A Comparison with Psoriasis.

Background/aim: Hidradenitis suppurativa (HS) is a chronic skin disease with a heavy impact on patients' quality of life (QoL). The aim of this study was to evaluate in detail the QoL impact of HS comparing it with other skin conditions, and in particular with psoriasis.

Methods: Patients with a diagnosis of HS were recruited.