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Biomedical subjects

D Reinharez

Publications and source records attributed to D Reinharez.

31 records · Page 2Linked to original sources
PubMedDate not supplied

[Pigmentation following sclerosis].

After discussing the psychological importance of the problem, the author stresses that the best treatment of pigmentations after sclerosis is prevention, based on experience and faultless technique (careful choice of sclerosants, local compression, evacuation of thrombi). The author then briefly reviews the pathophysiology of melanin dyschromias and their causes and presents the histological finding of a mixed origin for post-sclerosis pigmentations (melanin and iron). Various attempts at treatment are presented. The most effective form of treatment seems to be the percutaneous application of a mixture consisting of : -an iron chelator (desferoxamine), -an anti-inflammatory (alpha-chymotrypsin), -an anti-melanin agent (mequinol).

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Experience with sclerosis of the perforating veins].

The problem of sclerosis of the perforating veins, a subject of heated debate, seems now unanimously accepted. Indeed, their suppression is considered as important as sclerosis of the arches in preventing early and complete relapses. Their investigation can be clinical (examination of staged tourniquet), phlebographic or instrumental (thermography or Doppler). Their treatment can be either surgical (excellent in long reflux, perforating veins that are large in size and few in number) or medical (sclerotherapy). The latter present many variations with either direct injections in the perforating veins, telesclerosis above or below the perforating veins, telesclerosis on open veins after thrombectomy or extirpation with a Bassi hook. But whatever the technique used we cannot neglect the suppresion of short reflux which is a condition of the quality and duration of the results obtained.

Humans↗
PubMedDate not supplied

Varicose eczema.

The term "varicose eczema", although made acceptable by its use, is ambiguous and misleading. It would prompt us to believe that varicose eczema is different from common dermatological eczema. There is no such difference, and it would be more correct to speak of eczema of the varicose patient. The development of eczema in the case of a varicose patient may: --either develop in the case of a varicose patient who does not normally suffer from eczematous dermatosis; in this case static dermatitis represents a point of local reference for an eczematous crisis triggered off by a general factor and finding there a zone of reduced resistance; --or develop in the case of a known habitual eczematic. In this case, venous stasis increases and maintains the eczema. In both cases no local dermatological treatment will be able to cure the eczema, which will develop into a critical condition often provoking the development of a leg ulcer, and will necessitate the suppression of the venous counter-current. To try and understand the pathological mechanism of "varicose eczema", we have to remember the rudiments of the physiology of the cutaneous barrier, familiar to dermatologists but less so to phlebologists, and also some elements of the physiopathology of venous insufficiency, and in particular the tissular elements following the pattern explained by Comel's Italian school, by the term "histo-angiological decompensation". The circulatory unit "arteries-capillaries-veins-lymphatic-vessels-tissues" form an ensemble which has to be taken into account, as any disorders in any one of these elements reacts on all the others. These elementary rudiments lead us to understand the importance of an integral aetiopathogenic picture of varicose eczema, and the importance of the multidisciplinary collaboration between phlebologists and dermatologists in order to treat this affection, the border-line of our two specialties.

Cellulitis↗
PubMedDate not supplied

[Impotence following stripping].

Among the iatrogenic complications of the surgery of varicose veins, the author has encountered several cases of impotence following stripping of the internal saphenous. Without rejecting the possibility of a psychogenic impotence due to the operation itself, he raises the question of the possible mechanism of this complication. Alter considering the vascularization of the erectile body and the haemodynamic process of erection, he reviews the arterial and venous causes of impotence and sets out the hypothesis which he feels to be the most plausible. Under the arch of the internal saphenous passes the external pudendal artery; injury to this does not usually produce any significant damage, since the erectile body of the penis is vascularized by the internal pudendal artery. But if as a result of a congenital anomaly of the internal pudendal, the supply derives from the external pudendal, ablation of the latter, sometimes carried out by surgeons in the course of ligature of the arch of the internal saphenous vein, could explain this complication. If this hypothesis proves correct, it would be necessary to require surgeons to touch the external pudendal artery in order to avoid this complication, which though exceedingly rare, is psychologically traumatic.

Erectile Dysfunction↗
PubMedDate not supplied

[Fitness and competitive sports in venous pathology].

Since chronic venous insufficiency is a constitutional disorder, the principles of healthy living can be of major importance in its prevention and treatment. Among these, the influence of physical activities has attracted the attention of the author, who has attempted to analyze the mechanisms of each sport in order to study its effects on the peripheral vessels. As a result of long terme comparative studies, he has been able to classify the various sports into two categories, the sports which are beneficial and those which are harmful in subjects with vulnerable veins. Into the first category come those activities which assist the physiological mechanisms assuring the return of venous blood, in particular walking, swimming, cycling and gymnastics. Into the second category come sports which involve risks of constriction, trauma, and jolting of the vertebral column (skating, rugby, tennis, etc.), as well as all competitive sports because of the risks of thromboses, often unrecognized, and of excessive efforts which strain the valvular mechanism.

Athletic Injuries↗
PubMedDate not supplied

[Effect of chronic venous insufficiency in gonarthrosis].

The author has been struck by the unexpected improvement of the gonarthrocace in several patients treated for varicose disorders by sclerotherapy. He puts forward the theory that stasis in varicose patients and inverse venous current provoke tissular anoxaemia and histo-angeial decompensation affecting not only the teguments but the bones and cartilage as well. The author first mentions vascularisation, with complications, of the knee, and various experiments carried out on animals, and then he gives the results of twenty years' work, which prove his theory. Out of several hundred patients with associated gonarthrocace and varices, 60% were improved by the treatment of their varices, a figure far above that of the percentage of cases improved by rheumatological treatment on its own. This seems to prove the importance of the venous factor in gonarthrocace.

Animals↗
PubMedDate not supplied

[Venous ecology].

The purpose of venous ecology is to study the effect of the environment on the peripheral vessels. It is very extensive but still little explored subject in need of multidisciplinary study. The author reviews some of the major problems of ecophlebology: --pollution and harmful effects of urban life (atmospheric pollution, stress and influence of noise on the vessels); --the influence of habitat (furniture, ergonomics, urbanism, sociological studies and under-floor heating); --the cites new research on terrestrial electro-magnettism, meteoropathology, biological clocks and the influence of the mass media. In conclusion he hopes that ecophlebology will be the object of research which will permit a better understanding, and hence better control, of the pathological mechanisms resulting from the environment.

Culture↗
PubMedDate not supplied

[Effects of various sport activities on peripheral venous diseases].

The study of the influence of different sporting activities on peripheral venous pathology should be based on venous physiology and precise understanding of the technology of each sport (study of the movements, positions, and muscles brought into play, the rhythm, the material employed, the risks run). At the conclusion of a long study on sportsmen of both average and highly competitive ability, and on yogis, the author was able, by means of a simple methodology applicable to all physical activity, to classify the principal sports into two categories: those which improve and those which work against the peripheral venous circulation. However he does not recommend a complete ban on the harmful sports in highly motivated patients, but rather that they should counter the disadvantages by performing antagonistic movements.

Humans↗