Erosive Hand Osteoarthritis is Associated with Subclinical Atherosclerosis and Endothelial Dysfunction

Chronic inflammatory disorders have been associated with accelerated atherosclerosis and increased cardiovascular (CV) risk. Recent evidence suggests that erosive hand osteoarthritis (EOA) has considerable inflammation; therefore, we examined the presence of subclinical atherosclerosis and endothelial dysfunction in EOA. Twenty-four patients with EOA and 24 age- and sex-matched healthy individuals without clinical OA were included in the study. No subject had a history of CV disease. Intima-media thickness (IMT) and atheromatous plaques in the common carotid and common femoral arteries were measured by Doppler ultrasonography. The endothelium-dependent, flow-mediated dilatation (FMD) and endothelium-independent, sublingual glyceryl trinitrate (NTG)-induced dilatation (NMD) of the brachial artery were assessed. The EOA patients had significantly elevated systolic and diastolic blood pressure (p\u3c0.001 for both). The 10-year risk of general CV disease, as predicted with the Framingham Risk Score, was similar in patients and controls (p=0.18). IMT of both common carotid and common femoral artery were increased in EOA (p=0.01 and p\u3c0.01, respectively), but the frequency of atherosclerotic plaques was not increased. There was no difference in FMD and NMD between the two groups, but the difference between FMD and NMD was increased in EOA. In conclusion, this small controlled study showed an association between EOA and subclinical atherosclerosis that cannot be fully attributed to traditional CV risk factors, as assessed by the Framingham score. These results suggest that chronic, low-grade inflammation is implicated in atherosclerosis in EOA

Morphological and Haemodynamic Implications of Carotid Artery Endarterectomy vs. Stenting

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Groin surgical site infection incidence in vascular surgery with intradermal suture versus metallic stapling skin closure. A study protocol for a pragmatic open-label parallel-group randomized clinical trial (VASC-INF trial)

Background: Surgical site infection is 1 of the most frightening complications in vascular surgery due to its high morbimortality. The use of intradermal sutures for skin closure might be associated with a reduction in infections incidence. However, the data available in the literature is scarce and primarily built on low-evidence studies. To our knowledge, no multicenter clinical trial has been published to assess if the intradermal suture is associated with a lower surgical site infection incidence than metallic staples in patients who will undergo revascularization surgery requiring a femoral approach. Methods: VASC-INF is a pragmatic, multicenter, multistate (Spain, Italy, and Greece), randomized, open-label, clinical trial assessing the surgical site infection incidence in patients undergoing revascularization surgery requiring a femoral approach. Patients will be randomized on a 1:1 ratio to intradermal suture closure (experimental group) or to metallic staples closure (control group).The primary outcome is the number (percentage) of patients with surgical site infection (superficial and/or deep) associated with a femoral approach up to 28 (±2) days after surgery. Among the secondary outcomes are the number (percentage) of patients with other surgical wound complications; the number (percentage) of patients with surgical site infections who develop sepsis; type of antibiotic therapy used; type of microorganisms' species isolated and to describe the surgical site infection risk factors. Discussion: Intradermal suture closure may be beneficial in patients undergoing revascularization surgery requiring a femoral approach. Our working hypothesis is that intradermal suture closure reduces the incidence of surgical site infection respect to metallic staples closure

Corrigendum to "European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. [Eur J Vasc Endovasc Surg (2022) 63, 184-267]"

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Editor's Choice – European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs

Corrigendum: Volume 64, Issues 2–3, 2022, 284-285Peer reviewe

THE ROLE OF HIGHLY SELECTIVE VAGOTOMY AND PROSTAGLANDINS AGAINST THE INJURIOUS EFFECTS OF NON STEROIDAL ANTIINFLAMMATORY DRUGS OF THE GASTRODUODENAL MUCOSA

THE AIM OF THIS STUDY WAS TO ASSESS THE EFFECTIVENESS OF HIGHLY SELECTIVE VAGOTOMY (HSV) AND/OR MISOPROSTOL IN THE PROTECTION OF THE GASTRODUODENAL MUCOSA FROM INJURIOUS EFFECT OF THE DICLOFENAC SODIUM (DS). FORTY MONGREL DOGS WERE RANDOMLY ALLOCATED INTO 4 GROUPS OF 10 ANIMALS EACH. DS (1MG/KG BODY WEIGHT) WAS GIVEN I.M FOR 12 CONSECUTIVE DAYS TO THE ANIMALS OF THE GROUP I, WHILE IN THOSE OF THE GROUP II A HSV WAS PERFORMED AND A MONTH LATER DS WAS GIVEN AS IN THE PREVIOUS GROUP. DS WAS GIVEN IN COMBINATION H MISOPROSTOL (200 MCG PER OS QID) FOR12 DAYS IN THE ANIMALS OF THE GROUP III. HSV WAS CARRIED OUT IN THE ANIMALS OFTHE GROUP IV AND A MONTH LATER DS AND MISOPROSTOL WERE GIVEN AS IN THE GROUP III. ALL THE ANIMALS WERE SACRIFICED AFTER THE COMPLETION OF THE DRUG ADMINISTRATION AND THE GASTRODUODENAL MUCOSA WAS EXAMINED FOR MACROSCOPIC AND HISTOLOGIC LESIONS. THE FINDINGS SHOWED THAT: A) THE MUCOSAL LESIONS OF GASTROPATHY DUE TOTHE INJURIOUS EFFECT OF DS WERE MORE FREQUENTLY LOCATED IN THE STOMACH THAN INTHE DUODENUM (GROUP I, P=O.03, MCNEMAR TEST), B) HSV ALONE AND MISOPROSTOL ALONE DID NOT PROTECT GASTRODUODENAL MUCOSA FROM THE INJURIOUS EFFECT OF DS (GROUPII, P=0,474 AND GROUP III, P=0,08 AND P=0,65, FISHER'S EXACT TEST) AND C) THE COMBINATION OF HSV WITH MISOPROSTOL DID PROTECT THE GASTRIC MUCOSA (GROUP IV, P=0,007, FISHER'S EXACT TEST) WHILE THE PROTECTION THAT THIS COMBINATION OFFEREDTO THE DUODENAL MUCOSA WAS NOT SIGNIFICANT (GROUP IV, P=0,08, FISHER'S EXACT TEST).ΣΚΟΠΟΣ ΗΤΑΝ Η ΜΕΛΕΤΗ ΤΗΣ ΔΥΝΑΤΟΤΗΤΑΣ Η ΥΠΕΡΕΚΛΕΚΤΙΚΗ ΔΙΑΤΟΜΗ ΤΩΝ ΠΝΕΥΜΟΝΟΓΑΣΤΡΙΚΩΝ ΝΕΥΡΩΝ (ΥΔΠΝ) ΚΑΙ Η ΜΙΣΟΠΡΟΣΤΟΛΗ ΝΑ ΠΡΟΣΤΑΤΕΥΣΟΥΝ, ΧΩΡΙΣΤΑ 'Η ΣΕ ΣΥΝΔΥΑΣΜΟ,ΤΟ ΓΑΣΤΡΟΔΩΔΕΚΑΔΑΚΤΥΛΙΚΟ ΒΛΕΝΟΓΟΝΟ (ΓΔΒ) ΑΠΟ ΤΗ ΒΛΑΠΤΙΚΗ ΔΡΑΣΗ ΤΗΣ ΝΑΤΡΙΟΥΧΟΥ ΔΙΚΛΟΦΑΙΝΑΚΗΣ (ΝΔ). 40 ΠΕΙΡΑΜΑΤΟΖΩΑ ΣΚΥΛΟΙ ΧΩΡΙΣΘΗΚΑΝ ΣΕ 4 ΙΣΑΡΙΘΜΕΣ ΟΜΑΔΕΣ. ΣΤΗΝ ΟΜΑΔΑ Ι ΧΟΡΗΓΗΘΗΚΕ ΝΔ, 1MG/KG. ΒΣ, Ι.Μ., ΓΙΑ 12 ΣΥΝΕΧΕΙΣ ΗΜΕΡΕΣ, ΕΝΩ Η ΟΜΑΔΑΙΙ ΥΠΟΒΛΗΘΗΚΕ ΣΕ ΥΔΠΝ ΚΑΙ ΜΕΤΑ 1 ΜΗΝΑ ΧΟΡΗΓΗΘΗΚΕ, ΟΜΟΙΩΣ ΜΕ ΤΗΝ ΟΜΑΔΑ Ι, ΝΔ. ΣΤΗΝ ΟΜΑΔΑ ΙΙΙ ΧΟΡΗΓΗΘΗΚΑΝ ΤΑΥΤΟΧΡΟΝΩΣ, ΓΙΑ 12 ΣΥΝΕΧΕΙΣ ΗΜΕΡΕΣ, ΜΙΣΟΠΡΟΣΤΟΛΗ, 200 MG/6H, P.O. ΚΑΙ ΝΔ ΟΠΩΣ ΚΑΙ ΠΑΡΑΠΑΝΩ ΕΝΩ Η ΟΜΑΔΑ IV ΥΠΟΒΛΗΘΗΚΕ ΣΕ ΥΔΠΝ ΚΑΙ ΜΕΤΑ 1 ΜΗΝΑ ΕΛΑΒΕ ΜΙΣΟΠΡΟΣΤΟΛΗ ΚΑΙ ΝΔ ΟΠΩΣ Η ΟΜΑΔΑ ΙΙΙ. ΣΤΗΝ ΟΜΑΔΑ Ι ΟΛΑ ΤΑ ΠΕΙΡΑΜΑΤΟΖΩΑ ΕΙΧΑΝ ΒΛΑΒΕΣ ΣΤΟ ΣΤΟΜΑΧΟ ΚΑΙ 4 ΕΙΧΑΝ ΣΤΟ ΔΩΔΕΚΑΔΑΚΤΥΛΟ, ΣΤΗΝ ΟΜΑΔΑ ΙΙ ΒΛΑΒΕΣ ΣΤΟ ΣΤΟΜΑΧΟ ΕΙΧΑΝ 8 ΚΑΙ ΣΤΟ ΔΩΔΕΚΑΔΑΚΤΥΛΟ 4, ΣΤΗΝ ΟΜΑΔΑ ΙΙΙ ΒΛΑΒΕΣ ΣΤΟ ΣΤΟΜΑΧΟ ΕΙΧΑΝ 6 ΚΑΙ ΣΤΟ ΔΩΔΕΚΑΔΑΚΤΥΛΟ 6, ΕΝΩ ΣΤΗΝ ΟΜΑΔΑ IV ΒΛΑΒΕΣ ΣΤΟ ΣΤΟΜΑΧΟ ΕΙΧΑΝ ΜΟΝΟ 2 ΚΑΙ ΟΛΑ ΕΙΧΑΝ ΑΝΕΠΑΦΟ ΔΩΔΕΚΑΔΑΚΤΥΛΟ. ΣΥΜΠΕΡΑΣΜΑΤΙΚΑ: Α) Η ΒΛΑΠΤΙΚΗ ΔΡΑΣΗ ΤΗΣ ΝΔ ΑΦΟΡΑ ΚΥΡΙΩΣ ΣΤΟ ΣΤΟΜΑΧΟ (ΟΜΑΔΑ Ι, Ρ=Ο,03, MCNEMAR TEST), Β) Η ΥΔΠΝ ΚΑΙ Η ΜΙΣΟΠΡΟΣΤΟΛΗ, ΧΩΡΙΣΤΑ, ΔΕΝ ΠΡΟΣΤΑΤΕΥΣΑΝ ΤΟ ΓΔΒ (ΟΜΑΔΑ ΙΙ, Ρ=Ο,474, ΚΑΙ ΟΜΑΔΑ ΙΙΙ, Ρ=0,08 ΚΑΙ Ρ=0,65, FISHER'S EXACT TEST), Γ) Ο ΣΥΝΔΥΑΣΜΟΣ ΥΔΠΝ ΚΑΙ ΜΙΣΟΠΡΟΣΤΟΛΗΣ ΠΡΟΣΤΑΤΕΥΣΕ ΣΗΜΑΝΤΙΚΑ ΤΟ ΣΤΟΜΑΧΟ ΕΝΩ Η ΠΡΟΣΤΑΣΙΑ ΣΤΟ ΔΩΔΕΚΑΔΑΚΤΥΛΟ ΔΕΝ ΗΤΑΝ ΣΗΜΑΝΤΙΚΗ (ΟΜΑΔΑ IV, Ρ=0,007 ΚΑΙ Ρ=0,08, FISHER'S EXACT TEST)