PurposeTo identify risk factors for recurrent thromboembolic events (RTEs) and define the optimum duration of treatment with tinzaparin in patients with superficial vein thrombosis (SVT) of the lower limbs.Materials and MethodsA total of 147 consecutive patients with significant SVT were treated with subcutaneously administered tinzaparin. The composite primary endpoint of the study was RTE, deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) at 120 days. Patients were stratified into group A, where patients received a variable dose of tinzaparin for up to 60 days (n=98), and a subsequent group B-ext, where patients received a standardized intermediate dose of tinzaparin (n=49) for 90 days.ResultsRTEs occurred in 15/147 patients (10.2%), including recurrent SVT (n=10), DVT (n=4) and fatal PE (n=1). RTEs were less frequent in group B-ext (0% vs. 15.3% for group A, P=0.004), a difference that remained significant at the one-year follow-up. Clinically extensive SVT was an independent predictor for RTEs (hazard ratio, 5.94; 95% confidence interval, 2.05–17.23; P=0.001, Cox regression). Predictors or DVT or PE in group A included clinically extensive SVT (P=0.004), absence of local pain (P=0.023) and the ultrasound findings of superficial axial vein thrombosis (any, P=0.006 or isolated, P=0.036) and multiple thrombosed superficial venous sites (P<0.001).ConclusionAn extended three-month regimen of tinzaparin in patients with SVT of the lower limbs is more effective than a shorter course and may be desirable in patients with risk factors.
The human papillomavirus (HPV) vaccine protects against HPV-related disease. The aim of this study was to assess acceptance of HPV vaccination among female Greek students. A sample of 573 students aged 18-25 years participated in the present study. Interviews were performed using a structured questionnaire. Of the respondents, 3% were not aware of the HPV vaccine. Of the subjects, 10.47% had been administered the HPV vaccine. Of the respondents \vho had not been administered the vaccine, 43.86% were not willing to accept it because of the rumors of serious side effects. The results highlight the need for additional education and health promotion regarding HPV vaccination and cervical cancer prevention.
Among patients with varicose veins, GECS seem effective in ameliorating symptoms, particularly pain or aching, compared with placebo stockings after 1 week of use. Long-term studies are justified.
Cervical cancer is a major cause of death in the developing world. The Papanicolaou (Pap) smear is a screening test that detects abnormal cells before they advance to cancer. The objective of this study was to assess the knowledge, attitude, and practice of cervical cancer screening among Greek students. A sample of 472 female students participated in the present study. Interviews were performed using a structured questionnaire. Of the participants, 94.07% were aware of the Pap test and 67.34% reported that the Pap test should be done yearly. The majority of them were informed about cervical cancer screening test by their parents. Of the participants, 44.82% had received Pap testing at least once in their life, whereas 36.2% had a Pap test yearly. The reported mean time of the respondents' first Pap test was 13.3±10.6 months after their first sexual intercourse. The reasons given by the participants for being noncompliant were lack of appreciation of the importance of the screening, embarrassment, fear, and high cost. Of the participants, 9.23% declared that those who had been administered the human papillomavirus vaccine do not need a Pap test. The results highlight the need for additional education and health promotion regarding cervical cancer screening.
Our study has demonstrated that the repositionable GORE EXCLUDER has important safety characteristics compared with the original device and equivalent long-term effectiveness. Additional benefit was obtained with the use of the Gore Dryseal introducer sheath.
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