[Effectiveness of pentoxifylline and of bio-electromagnetic therapy in lower limb obliterative arterial disease]. / A pentoxifillin és a bioelektromágnes-regulációs kezelés hatása alsó végtagi obliteratív veroérbetegségben.

INTRODUCTION: There are limited therapeutic options to improve microcirculation. AIM: The question of the study was to investigate any potential beneficial effect of bio-electro-magnetic-regulation therapy on microcirculation in patients suffering from obliterative peripheral arterial disease including the circulation of lower extremities, as well as intermittent claudication. METHOD: Thirty patients suffering from obliterative peripheral arterial disease (Fontaine IIa and IIb) were recruited. The first step of the study was to determine the pain free and maximal walking distance with a treadmill unit. After the placebo period patients received 8 and 20 minutes bio-electro-magnetic-regulation treatment 16 times. After the treatment the pain free and maximal walking distance were measured again. In the second stage of the study the patients were treated by pentoxifylline infusions. RESULTS: Bio-electro-magnetic-regulation treatment increased the pain free period by 57.4% (p = 0.005) and the maximal walking distance by 36.6% (p = 0.042). The two forms of therapy together increased the pain free and maximal walking distance by 81.9% and by 84.0%, respectively. The combined therapy was very effective in contrast to placebo and bio-electro-magnetic-regulation treatment (p = 0.000373 and p = 0.00741, respectively). CONCLUSIONS: The bio-electro-magnetic-regulation therapy mainly affected the microvessels and pentoxifylline therapy rather had beneficial effects on hemorheology. The clinical effectiveness of combined therapy was good or excellent in 70% of patients.

[The efficacy and safety of acenocoumarol and warfarin therapy in patients with lower limb deep vein thrombosis]. / Az acenocumarol és a warfarin hatásossága és biztonságossága alsó végtagi mélyvénás trombózis kezelésében.

UNLABELLED: Only few studies are available on the comparison of the efficacy and safety of the acenocoumarol and warfarin. The authors treated patients with deep vein thrombosis according to latest recommendations using D-dimer measurements and duplex ultrasound exams. AIMS: To examine the efficacy and safety of the two anticoagulants in patients with lower limb deep vein thrombosis. METHODS: The authors included 100 consecutive patients with lower limb dee deep vein thrombosis. The patients were treated with acenocoumarol or warfarin in doses to achieve INR values between 2 and 3.5 for six months. After 6 months the authors performed physical examination, D-dimer measurements and ultrasound exams, and determined the rate of unchanged thrombotic process, as well as the rate of complete and incomplete recanalisations. RESULTS: There was no significant difference in the number of INR determinations during treatment between the two groups (acenocoumarol group 442, warfarin group 416). The INR values were in the therapeutic range in 71.2% and 75.4% of patients in the acenocoumarol and warfarin groups, respectively. Dose adjustment was necessary in 129 and 84 times in the acenocoumarol and warfarin groups, respectively (p = 0.0025). The therapy was optimally effective (INR value was within the therapeutic range throughout the treatment period) in 46% and 52% of patients in the acenocoumarol and warfarin groups, respectively. The thrombotic vein was completely recanalised in 91.9% of patients treated optimally, and only 80.4% of patients treated not optimally. There were 3 minor bleedings in the acenocoumarol and 4 minor bleedings in the warfarin groups, while one major bleedings occurred in both groups. CONCLUSIONS: The INR values were more stable in the warfarin group than in the acenocumarole group. In both groups the rate of complete vein recanalization was related to the rate of optimally stable INR values within the therapeutic range.