Since 2005, Dr. Mitar Vranic has cared for patients at Arizona's Western Vascular Institute. There, Dr. Mitar Vranic treats vascular conditions ranging from venous insufficiency to Klippel-Trenaunay Syndrome.
Since 2005, Dr. Mitar Vranic has cared for patients at Arizona's Western Vascular Institute. There, Dr. Mitar Vranic treats vascular conditions ranging from venous insufficiency to Klippel-Trenaunay Syndrome.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
Situs Inversus totalis is a genetic condition that causes the organs in the chest and abdomen to be positioned in a mirror image from their normal positions.
This gives an idea about the Signs/Symptom, Diagnosis, Treatment and Special concerns of the syndrome.
Diagnosis, management, workup in a case of Takayasu's arteritis. Definition, synonyms, history, epidimiology, pathophysiology, etiology of Takayasu's arteritis.
Situs Inversus totalis is a genetic condition that causes the organs in the chest and abdomen to be positioned in a mirror image from their normal positions.
This gives an idea about the Signs/Symptom, Diagnosis, Treatment and Special concerns of the syndrome.
Presentación realizada para mi clase de fisiopatología, se que esta incompleta pero espero sirva de algo.
La critica cosntructiva siempre es bien recibida
PWS is a rare congenital disorder of vascular system. Often confused with Klippel trenaunay syndrome as almost similar symptoms.In PWS, capillary & arterio-venous malformation, arteriovenous fistula and overgrowth of a limb can occur together.
Abstract—Klippel-Trenaunay syndrome (KTW) is a rare, sporadic syndrome characterized by a triad of port-wine stain, varicose veins with or without venous malformations, and bony and soft tissue hypertrophy. It usually affects only one extremity, organ involvement is uncommon. A case of 17-year-old boy with this syndrome having solid viscous organ involvement was observed at surgery Outdoor. This case is rare so it was reported. Splenic lymphangiomatosis is also observed in this KTW syndrome case as association of AVM and lymphangioma together in spleen is rarest which was observed in this case. So it is a very rare case.
Los días 20 y 21 de octubre de 2016, la Fundacion Ramón Areces organizó un simposio internacional para analizar las 'Enfermedades raras de la piel: de la clínica al gen y viceversa'. El doctor Fernando Larcher Laguzzi, del CIEMAT-Universidad Carlos III de Madrid-IIS Fundación Jiménez Díaz, ejerció de coordinador.
La rivascolarizzazione degli arti inferiori nel paziente anziano: rischi e va...ASMaD
Presentazione a cura del Professor Angelo Cioppa - XII° Congresso Nazionale FIMeG 2018 - The Silver Tsunami: l'anziano fra appropriatezza e farmaeconomia
IMAGES OF A COMPLEX CASE OF MULTIPLE ANEURYSMAL DISEASE IN A 58 YEAR OLD MAN
IMMAGINI DI UN CASO COMPLESSO DI MALATTIA POLINEURISMATICA
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
the IUA Administrative Board and General Assembly meeting
Recurrence of Klippel-Trenaunay syndrome symptoms after surgery: a single case treated with foam sclerotherapy
1. Dr. Edoardo Cervi
Dr. Maurizio Ronconi
Clinica Chirurgica - Spedali Civili di Brescia
Recurrence of Klippel-Trenaunay syndrome
symptoms after surgery: a single case
treated with foam sclerotherapy
2. HISTORY
In 1900 the French physicians Maurice Klippel and Paul Trenaunay described 2
patients with a port-wine stain and varicosoties of an extemity associated with
soft issue and bone hypertrophy and coined the term “naevus vasculosus
osteohypertrophicus”
In 1907 the eminent London physician F. Parkers Weber described
a patient with 3 aforerementioned symptoms as well as an
arteriovenous malformation of the affected extremity. He termed
the process hemangiectatic hypertrophy
Thus 1918 is became know Klippel-Trenaunay-Weber syndrome
Today, conflicting opinion exist in the literature as whether to
separately designate the original triad as Klippel Trenaunay and the
triad with arteriovenous malformation as Parkes Weber syndrome
3. Definition
congenital mixed vascular malformation
•
with anomalous vascular elements: veins capillaries
lymphatics
•
with abnormal bone growth
•
also called “angio-osteo-hypertrophic syndrome”
(AOH)
1. www.orpha.net
2. Klippel-Trenaunay syndrome: current management. P. Gloviczi, D J Driscoll; Phlebology 2007; 22:
291-2983.
5. Etiology
●
Unknown
●
Some familiar cases with autosomal dominant
inheritance
●
Intrauterine damage to the sympathetic ganglia
1. www.orpha.net
2. Klippel-Trenaunay syndrome: current management. P. Gloviczi, D J Driscoll; Phlebology 2007; 22:
291-2983.
4. Spinal arteriovenous malformations associated with Klippel-Trenaunay-Weber syndrome: a literature
search and report of two cases. M Rohany, A Shabani, O Arafat et al; AJNR 2007; 28: 584-589
5. Klippel-Trenaunay syndrome: diagnostic criteria and hypotesis on etiology. C E Oduber, C M van der
Horst, R C Hennekam; Ann Plast Surg 2008; 60(2): 217-223
7. It belongs to arteriovenous malformations
ISSVA – International Society for the Study of Vascular Anomalies- classification
(Rome, 1996) 3
Vascular
malformations
simple complex
Capillary (C) A-V fistula
Venous (V) A-V malformations
Lymphatics (L) CVLM
Arterious (A) CVM
LVM
CAVM
CLAMV
KTS is the most frequent type of complex
malformation seen at Vascular Malformation
Classification
8. Clinical features
Classical triad of:
1- capillary malformations (port wine stain)
2- soft tissue and bone hypertrophy, or, occasionally,
hypotrophy (1 or more limbs)
3- atypical, mostly lateral, varicosity
... but wide spectrum of presentation!
(also incomplete forms)
9. Clinical features
Main symptoms:
●
hemangiomas, lymphangiomas, varicosity
●
different length of the limbs (up to 10 cm)
●
haemorrhage ( rectal bledding, intracerebral or
intraspinal, hematuria )
10. Clinical features
2. Klippel-Trenaunay syndrome: current management. P.
Gloviczi, D J Driscoll; Phlebology 2007; 22: 291-2983.
4. Spinal arteriovenous malformations associated with
Klippel-Trenaunay-Weber syndrome: a literature search
and report of two cases. M Rohany, A Shabani, O Arafat et
al; AJNR 2007; 28: 584-589
6. Klippel-Trenaunay syndrome: incidence and treatment
of genitourinary sequelae. D A Husmann, S R Rathburn, D J
Driscoll; J Urol 2007; 177(4): 1244-1249
7. Lower gastrointestinal bleeding, hematuria and splenic
hemangiomas in Klkippel-Trenaunay syndrome: a case
report and literature review. O Kocaman, A Alponat, C
Aygun et al; Turk J Gastroenterol 2009; 20(1): 62-66
8. Urogenital involvement in the Klippel-Trenaunay-Weber
syndrome. Treatment options and results. F C Vicentini, F
T Denes, C M Gomes; International Braz J Urol 2006; 32(6);
697-704
9. The Klippel-Trenaunay syndrom associated with
multiple visceral arteries aneurysms. S Pourhassan, D
Grotemeyer, V Klar et al; Vasa 2007; 36(2): 124-129.
13. Diagnosis
●
Clinical examination of the limbs
●
X- rays of the long bones
●
Duplex scanning
●
MRI
●
CT
●
Venography
1. www.orpha.net
2. Klippel-Trenaunay syndrome: current management. P. Gloviczi, D J Driscoll; Phlebology 2007; 22: 291-2983.
7. Lower gastrointestinal bleeding, hematuria and splenic hemangiomas in Klkippel-Trenaunay syndrome: a case
report and literature review. O Kocaman, A Alponat, C Aygun et al; Turk J Gastroenterol 2009; 20(1): 62-66
10. Prenatal diagnosis and hemodynamic evaluation of Klippel-Trenaunay-Weber syndrome. D Paladini, A Lamberti,
A Teodoro et al; Ultrasound Obstet Gynecol 1998; 12: 215-217
11. Klippel-Trenaunay syndrome. M Samimi, G Lorette; Presse Med 2010
15. Management
• Compression (is the hallmark of conservative management)
• Surgical treatment
• Subfascial endoscopic perforator surgery (SEPS)
• Selective endovenous thermal ablation
• Sclerotherapy with foam
• Deep vein reconstructions (rare cases)
16. Treatment of Venous Malformations
With Sclerosant in Microfoam Form
Juan Cabrera, MD; Juan Cabrera, Jr, MPharm; Ma
Antonia Garcıa-Olmedo, DPharm; Pedro Redondo, MD,
PhD
Vascular Surgery Clinic, Granada, Spain
Arch Dermatol. 2003 Nov;139(11):1494-6
Efficacy and safety of microfoam sclerotherapy in a patient
with Klippel-Trenaunay syndrome and a patent foramen
ovale.
Redondo P, Bastarrika G, Sierra A, Martínez-Cuesta A, Cabrera
J.
Unit of Vascular Malformations, Department of Dermatology,
University Clinic of Navarra, 31008 Pamplona, Spain.
predondo@unav.es
Arch Dermatol. 2009 Oct;145(10):1147-51
Venous angiomata: treatment with sclerosant foam.
Pascarella L, Bergan JJ, Yamada C, Mekenas L.
Department of Bioengineering, University of California San
Diego, La Jolla, CA, USA.
Ann Vasc Surg. 2005 Jul;19(4):457-64
17. Case report
• Inferior limb varix at birth
• 2 years old arthrocentesis right knee
• 4 years old arthrocentesis left knee
• 7 years old impair of function and left inferior limb pain;
– angiography (1982): small angiodysplasia new formation nourrished by a
muscular tract of deep femoral artery at its middle third; second new
formation in the soft tissue of the knee nourrished by genicolar lateral
inferior a. and by genicolar lateral superior a.;
• The patient is underwent a multiple surgical excisions of
angiodysplasias
18. Case report
• A 20 years old the patient presented with large varicosities,
swelling and pain
• Treated between June 2006 and June 2008 with ultrasound-
guided foam sclerotherapy (USFS)
• Sclerosant agent: Polidocanol 3%
• Foam produced by Tessari’s tecnique
• Number of sessions: 20,
• Dose utilized for each session: 4 - 8cc
19.
20.
21.
22.
23.
24.
25.
26. Case report
No major complications were encountered
The patient reported improvement in signs and
symptoms
The patient was very satisfied with the cosmetic
results
27. Conclusion 1
1. KTS is a mixed malformation with a vascular component
2. The management is complex and involves:
• predictionprediction of the disease (genetic evaluation)
• evaluationevaluation with diagnostic studies
• preventionprevention of vascular and orthopaedic compliacations,
• treatmenttreatment of clinical manifestations
28. 3. Sclerosant foam is a satisfactory tool to use in treating venous
angiomata including the Klippel-Trenaunay syndrome
4. Use of foam sclerotherapy in this experience has proven the tecnique
to be effective, pain free and durable in the short term
Conclusion 2
