Chronic Venous Insufficiency and Varicose Veins
A 52-year-old receptionist presents with an ulcer on her ankle of 1 year's duration. Narcotic analgesics once or twice a day and leg elevation reduce the pain. She has not had diabetes and does not smoke. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of gran...
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| Veröffentlicht in: | The New England journal of medicine 2009-05, Vol.360 (22), p.2319-2327 |
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| creator | Raju, Seshadri Neglén, Peter |
| description | A 52-year-old receptionist presents with an ulcer on her ankle of 1 year's duration. Narcotic analgesics once or twice a day and leg elevation reduce the pain. She has not had diabetes and does not smoke. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
A 52-year-old woman presents with an ulcer on her ankle of 1 year's duration. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. How should she be evaluated and treated?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
Stage
A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer has a clean bed of granulation and is surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
The Clinical Problem
Chronic venous insufficiency is associated with a wide clinical spectrum . . . |
| doi_str_mv | 10.1056/NEJMcp0802444 |
| format | Article |
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A 52-year-old woman presents with an ulcer on her ankle of 1 year's duration. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. How should she be evaluated and treated?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
Stage
A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer has a clean bed of granulation and is surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
The Clinical Problem
Chronic venous insufficiency is associated with a wide clinical spectrum . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMcp0802444</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Waltham, MA: Massachusetts Medical Society</publisher><subject>Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Compression therapy ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; General aspects ; Legs ; Medical sciences ; Physical examinations ; Varicose veins ; Veins & arteries</subject><ispartof>The New England journal of medicine, 2009-05, Vol.360 (22), p.2319-2327</ispartof><rights>Copyright © 2009 Massachusetts Medical Society. All rights reserved.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-27786c06314289d4ae5a98b83ee06b13311ef9342b36f8fcb47110037da58dd33</citedby><cites>FETCH-LOGICAL-c473t-27786c06314289d4ae5a98b83ee06b13311ef9342b36f8fcb47110037da58dd33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMcp0802444$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.nejm.org/doi/full/10.1056/NEJMcp0802444$$EHTML$$P50$$Gmms$$H</linktohtml><link.rule.ids>314,776,780,2746,2747,26080,27901,27902,52357,54039</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21526090$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Raju, Seshadri</creatorcontrib><creatorcontrib>Neglén, Peter</creatorcontrib><title>Chronic Venous Insufficiency and Varicose Veins</title><title>The New England journal of medicine</title><description>A 52-year-old receptionist presents with an ulcer on her ankle of 1 year's duration. Narcotic analgesics once or twice a day and leg elevation reduce the pain. She has not had diabetes and does not smoke. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
A 52-year-old woman presents with an ulcer on her ankle of 1 year's duration. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. How should she be evaluated and treated?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
Stage
A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer has a clean bed of granulation and is surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
The Clinical Problem
Chronic venous insufficiency is associated with a wide clinical spectrum . . .</description><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Compression therapy</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. 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Vascular system</topic><topic>Compression therapy</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>General aspects</topic><topic>Legs</topic><topic>Medical sciences</topic><topic>Physical examinations</topic><topic>Varicose veins</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raju, Seshadri</creatorcontrib><creatorcontrib>Neglén, Peter</creatorcontrib><collection>Pascal-Francis</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raju, Seshadri</au><au>Neglén, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic Venous Insufficiency and Varicose Veins</atitle><jtitle>The New England journal of medicine</jtitle><date>2009-05-28</date><risdate>2009</risdate><volume>360</volume><issue>22</issue><spage>2319</spage><epage>2327</epage><pages>2319-2327</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>A 52-year-old receptionist presents with an ulcer on her ankle of 1 year's duration. Narcotic analgesics once or twice a day and leg elevation reduce the pain. She has not had diabetes and does not smoke. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
A 52-year-old woman presents with an ulcer on her ankle of 1 year's duration. Physical examination reveals an ulcer above the medial malleolus, with a clean bed of granulation and surrounded by hyperpigmented skin. How should she be evaluated and treated?
Foreword
This
Journal
feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
Stage
A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer has a clean bed of granulation and is surrounded by hyperpigmented skin. Pedal pulses are easily palpable. How should she be evaluated and treated?
The Clinical Problem
Chronic venous insufficiency is associated with a wide clinical spectrum . . .</abstract><cop>Waltham, MA</cop><pub>Massachusetts Medical Society</pub><doi>10.1056/NEJMcp0802444</doi><tpages>9</tpages></addata></record> |
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| ispartof | The New England journal of medicine, 2009-05, Vol.360 (22), p.2319-2327 |
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| language | eng |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; New England Journal of Medicine |
| subjects | Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Compression therapy Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous General aspects Legs Medical sciences Physical examinations Varicose veins Veins & arteries |
| title | Chronic Venous Insufficiency and Varicose Veins |
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