ABSTRACT
INTRODUCTION: Multi-component compression, inelastic, short stretched or coated strips bandages, and class 4 stockings have been recommended since 2010 by the French Superior Health Authority as first- and second-line treatment for venous leg ulcers. OBJECTIVES: Assess the prescribing habits and knowledge of general practitioners about compression therapy and determine factors predictive of prescriptions consistent with recommendations. METHODS: Evaluation study of professional practices conducted during a six-week period. A questionnaire was sent to 210 general practitioners asking them to report their prescribing practices and the last prescription written for a patient with venous ulcers. RESULTS: The response rate was 36.2% (76 responses). For the last patient seen, long stretched bands were prescribed by 50.8% of responders, stockings by 40% and multi-component compression by 7.7%. Stockings were class 2 for 87.7% of the prescriptions. Knowledge of short stretched bands and multi-component compression was reported by 45.8% and 38.9% of general practitioners respectively. Guidelines were followed by 10.8% of the physicians. No factor related to the general practitioner (age, sex, modalities of exercise, experience and education), to the patients (age, sex, under-nutrition, autonomy) or to the leg ulcer (size, exudates, course, complexity of care), was associated with compliance or not with the guidelines. General practitioner training enabled a non-significant improvement of prescriptions (14.3% vs 4%, P=0.24). CONCLUSION: Compliance with the guidelines for compression therapy is insufficient in general medicine. Better training and knowledge of modalities for compression therapy could be useful to improve prescription practices and encourage use of multi-component compression and short stretched bandages, known to be more effective and better tolerated.
Subject(s)
Compression Bandages , General Practitioners , Leg/blood supply , Practice Patterns, Physicians' , Varicose Ulcer/therapy , Adult , Aged , Aged, 80 and over , Female , France , Humans , Male , Middle Aged , Patient Compliance , Stockings, Compression , Surveys and QuestionnairesSubject(s)
Mitral Valve Insufficiency/complications , Pulmonary Edema/diagnostic imaging , Pulmonary Edema/etiology , Aged, 80 and over , Atrial Fibrillation/complications , Atrial Flutter/complications , Diagnosis, Differential , Diuretics/therapeutic use , Female , Humans , Mitral Valve Insufficiency/etiology , Oxygen Inhalation Therapy , Pulmonary Edema/therapy , Radiography , Risk Factors , Treatment Outcome , UltrasonographyABSTRACT
INTRODUCTION: The MYH9 syndrome is a group of rare autosomal dominant platelet disorders associating in most of the cases a macrothrombocytopenia and characteristic leukocyte inclusions. Clinical features may include renal, visual, or hearing impairment. The bleeding tendency is usually moderate. CASE REPORT: We report a 28-year-old-man, with an auto-immune haemolytic anaemia associated with a MYH9 syndrome. CONCLUSION: To our knowledge, this is the first report of such an association.
