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Objective: Despite recent advances in the field of venous thromboembolism (VTE) prophylaxis and adherence to guideline recommendations, VTE remains a serious problem, especially in high-risk groups. The aim of the present review was to summarize the evidence supporting the use of combined modalities, both physical and pharmacological, in VTE prevention. Methods: Using Medline, original studies on the value of combined modalities in VTE prevention were identified. Keywords used for physical methods included elastic stockings and intermittent pneumatic compression, and for pharmacological methods included unfractionated and low molecular weight heparin. Relevant articles from their bibliography were also retrieved. Results: Combined pharmacological and physical modalities were more effective than each modality alone in a variety of specialties, including orthopaedic, general and cardiac surgery, as shown by 14 of the 18 randomized or case-control studies retrieved. Mean reduction in VTE incidence was 69% (range 16–100%). Conclusion: Combined modalities are more effective than single modalities in VTE prophylaxis. These results endorse their use, especially in high-risk patients, and support this otherwise typical recommendation of the consensus documents on VTE prophylaxis. [ABSTRACT FROM AUTHOR]

Background: The correlation of clinical and laboratory findings with various imaging techniques in obese patients is difficult. Colour duplex Doppler is of particularly limited value in fat individuals. The Doppler Perfusion Index (DPI) measures the ratio of hepatic arterial to total liver blood flow and seems to be more accurate in the study of hepatic hemodynamics. The aim of the present study was to investigate the clinical use of DPI measurement of the liver in obesity. Methods: In the present prospective, open study we evaluated the DPI in 41 obese patients (body mass index (BMI) > 30 kg/m[sup 2]) and 18 volunteers with normal or slightly increased weight. Thirty patients of the study group underwent liver biopsy during bariatric surgery. In these patients liver histology was assessed and age, BMI, waist to hip ratio (WHR), DPI, liver function tests and serum triglycerides were measured. Results: Obese patients had significantly (P = 0.0036) higher DPI values (0.25 ± 0.138) than the healthy volunteers (0.15 ± 0.04). Multivariate analysis revealed that grade of fatty liver in the study group was inversely associated with DPI and positively depended on serum triglyceride and aspartate aminotransferase (ASAT) levels (fatty liver index = 1.03 × ASAT (IU/l) + 0.152 × triglyceride (mg%) - 49.75*DPI, with P < 0.0001 and r[sup 2] = 0.80). Conclusion: Grade of fatty liver in obese patients may be predicted from DPI, serum triglyceride and AST levels. The proposed index may be useful as a non-invasive diagnostic tool during the follow-up of patients with obesity-related fatty liver. [ABSTRACT FROM AUTHOR]

No randomized controlled clinical trials have investigated the role of postoperative adjuvant medical therapy in improving the results of deep venous reconstruction. Deep venous thrombosis (DVT) is an important complication following deep valve reconstruction. It may occur at the site of the repaired valve or alternatively in remote sites. There is evidence from randomized controlled trials in many surgical specialties indicating that the combination of anticoagulation and a mechanical method of prophylaxis has an important role in the reduction of postoperative DVT. This combination should be used in the postoperative management of deep venous reconstruction. Additional benefits of the mechanical methods of thromboprophylaxis are a reduction of the postoperative swelling and improved venous haemodynamics. [ABSTRACT FROM AUTHOR]

Examines the usefulness of a computerized texture analysis of carotid plaque ultrasonic images in identifying unstable plaques associated with ipsilateral neurological symptoms. Differentiation of carotid plaques with the use of images; Utilization of a computer software for the calculation of textural features of the plaque outlines; Specificity of the method.

Determines the association between computerized texture analysis of carotid plaque ultrasonic images and embolic computed tomography-brain infarction in patients presenting with hemispheric neurological symptoms. Assessment of images for the presence of juxtaluminal echolucent components; Application of principal component analysis; Number of cases with embolic infarcts.

This study was conducted to investigate the association between established and emerging cardiovascular risk factors with symptomatic carotid artery disease. Cross-sectional study included 124 patients with significant internal carotid artery stenosis. Smoking, hypertension, diabetes mellitus, serum lipoprotein, homocysteine, vitamin B,2, folate, cholesterol to high-density lipoprotein ratio, triglycerides,C-reactive protein, the cardiovascular risk score, and carotid plaque echostructure were assessed. Results: The asymptomatic and symptomatic groups did not differ in terms of gender distribution and severity of stenosis

The common carotid intima-media thickness (IMT) is considered as a marker of cardiovascular disease. However, it is less clear whether the common femoral IMT or the common carotidcommon femoral IMT can be of equal value. The aim of this pilot study was to validate the common carotid-common femoral IMT as a marker of premature atherosclerosis in asymptomatic adults. Eighty-three symptom-free individuals were subjected to IMT measurement of both the common carotid and common femoral arteries with high-resolution ultrasonography. The Framingham Heart Study risk score was calculated for each subject.

Temporal artery is superficially exhibited and easily traumatized. Rarely, a minor and blunt trauma, especially in elderly who are under anticoagulants, can cause a pseudoaneurysm. Diagnosis should be based, primarily, on history and physical examination and secondarily on duplex ultrasound scanning which will lead to confirmation and preoperative planning. The therapeutical plan consists of surgical ligation and excision of the aneurysm. Surgery can be performed under local anesthesia with no postoperative major or minor complications. Endovascular approach consists of catheter embolization and remains a second option due to the risk of complications and the inconclusive results. On this review, authors present a case of an 80-year-old male with a pseudoaneurysm of superficial temporal artery. [ABSTRACT FROM AUTHOR]

Assessment of the association of established and emerging cardiovascular risk factors with the arterial intima-media thickness (IMT) in arteriopaths with unisegmental or multisegmental disease. The common carotid and common femoral IMT was measured with high resolution ultrasound in patients with asymptomatic carotid artery disease only and patients with asymptomatic carotid disease and symptomatic cardiovascular disease elsewhere coronary artery or lower limb ischaemic disease and was correlated to age, gender, body mass index, smoking, hypertension, diabetes mellitus, haematocrit, serum creatinine, fibrinogen, total cholesterol, triglycerides, low-density, high density lipoproteins (HDL) and total cholesterol to HDL ratio.