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Biomedical subjects

Raj Mani

Publications and source records attributed to Raj Mani.

18 recordsLinked to original sources
PubMed2006

A review of the microcirculation in skin in patients with chronic venous insufficiency: the problem and the evidence available for therapeutic options.

Impairment of the cutaneous microcirculation is a major predisposing factor in inflammation and ulceration in patients with chronic venous insufficiency (CVI). Increase of capillary filtration rate predisposes to the formation of edema. Local lymphedema is a complication of CVI, often underdiagnosed. This review is focused on CVI but excludes the complication of ulceration. Treatment of microcirculatory dysfunction can be done by pharmacologic intervention or compression therapy or using a combination of both. This review is focused on drugs that have been evaluated by randomized prospective controlled trials. The following compounds are discussed: horse chestnut seed extracts, flavonoids, red vine leaves extracts, total triterpenic fraction of Centella asiatica (L), prociadins, calcium dobesilate, and pentoxifylline. The microcirculatory effects of compression therapy using bandages or stockings are also reviewed. The major microcirculatory effects that have been shown are the reduction of capillary filtration rate and improvements in levels of transcutaneous partial pressures of oxygen and carbon dioxide (TcPO(2) and TcPCO(2)). Available data suggest that a combination of pharmacologic and compression therapy may have some additive effects.

Chronic Disease↗
PubMed2005

A nurse-led ambulatory care pathway for patients with deep venous thrombosis in an acute teaching hospital.

This article describes the management of deep vein thrombosis (DVT) using an ambulatory nurse-led pathway and the compression technique using duplex ultrasound. This pathway permits the management of the "walking wounded" as well as other patients at varying risks of having DVT and in so doing has changed the approach toward the management of this common clinical event. The success of the described pathway is attributed to the development of low molecular weight heparin and the reliability of diagnostics.

Ambulatory Care↗
PubMed2004

Outcomes.

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Editorial↗
PubMed2002

The role of ultrasound in lower extremity wound management.

Imaging and hemodynamic information are essential in determining the etiology of lower extremity wounds. Ultra- sound offers a noninvasive method of studying vessel walls and measuring blood flow, thereby providing reliable diagnostic data. This article reviews the role of ultrasound in the management of the lower extremity wound.

Journal Article↗
PubMedDate not supplied

Some effects of sustained compression on ulcerated tissues.

Sustained leg compression is the first line of treatment for patients with chronic venous ulcers. The success rates of this treatment vary, and the mode(s) of action are not well understood. In this study, tissue oxygen tension (TcPO2), surface pH, and reactive hyperemia measurements were made to observe changes associated with sustained compression in patients with chronic venous ulcers. Patients with chronic venous ulcers (n = 20, 13 F, 7 M, median age 65.5 years, median ulcer size 13.9 cm2) were assigned to the same treatment, wound dressings, and 4-layer bandaging during a 24-week period. Duplex ultrasound, venous refilling time, skin tissue oxygen, and ulcer surface pH were measured at defined time points. Ulcer areas were calculated from contour traces done at regular dressing changes. The difference between ulcer surface pH and control values measured proximally on the same leg diminished with healing (p = 0.02), which occurred despite the evidence of deep venous reflux. Ulcers with smaller initial areas healed quicker (p = 0.003). A greater likelihood of healing was observed in women (p = 0.017). Sustained compression may potentiate healing by acting on the microcirculation in ulcerated tissues.

Aged↗