Venous and lymphatic disease: A historical review
Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki in Handbook of Venous and Lymphatic Disorders, 2017
Prior to the discovery of anticoagulants, strict bed rest for many weeks was the cornerstone of VTE treatment. The rationale behind this treatment was that during the “acute phase” of DVT, the thrombus was not fixed to the vessel and was at high risk of migration,8 and the thrombus could be secured in place by restricting movement of the limb. Patients’ lower limbs were set in iron splints to prevent movement, and special reclining orthopedic beds were used to optimize venous return. The application of a warm compress was also used to reduce vasospasm and increase collateral circulation.8 Unfortunately, in addition to actually promoting thrombus formation and extension, prolonged immobilization was frequently associated with serious unpleasant consequences, such as lower extremity joint stiffness (ankyloses) and muscle atrophy (amyotrophia).8 Late in the nineteenth century, after observing that superficial vein thrombosis quickly vanished with the use of compression bandages, two German phlebologists (Fischer and Lasker) started prescribing compression bandages to their DVT patients. Despite their foresight and the appropriateness of their therapy, their approach was not popular due to the widespread teaching of prolonged bed rest as the most important treatment for DVT.8
Hair and Nail Manifestations of HIV Infection
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
Unlike infectious causes of periungual inflammation, surgical management of indinavir-induced paronychia is not recommended due to its high rate of recurrence. For minimally symptomatic patients, local measures and warm compresses may be sufficient.118 More aggressive treatment options include changing the antiretroviral therapy to a regimen not containing indinavir, while continuing to administer other protease inhibitors such as lamivudine.119 If it is not feasible to change therapy, topical application of a strong antimicrobial and anti-inflammatory agent may significantly improve the symptoms.111 Treatment of secondary bacterial and fungal infections may be necessary. The physician should carefully examine the hands and feet of the patient prior to initiating therapy with indinavir and document any changes that occur during treatment. Knowledge that indinavir can cause paronychia may help avoid unnecessary and invasive procedures, such as lateral matrixectomy.
Skin and Soft Tissue Infections
Thomas T. Yoshikawa, Shobita Rajagopalan in Antibiotic Therapy for Geriatric Patients, 2005
The treatment of choice for a paronychia is incision and drainage. Warm compresses or soaks with half-strength hydrogen peroxide can be provided. The presence of a subungual abscess requires nail plate removal. The degree of debridement depends on the degree of nail bed infection. Antibiotics are not necessary if the incision successfully achieves adequate drainage. If cellulitis is present, antibiotics are indicated. Cephalexin, which has activity against both S. aureus and streptococci, is a reasonable choice. If the infection is caused by MRSA, the antibiotic prescribed should include antibiotic that is active against MRSA as mentioned earlier.
The Efficacy of Warm Compresses in the Treatment of Meibomian Gland Dysfunction and Demodex Folliculorum Blepharitis
Published in Current Eye Research, 2020
Orla Murphy, Veronica O’ Dwyer, Aoife Lloyd-Mckernan
Traditionally, home based warm compresses were carried out using a warm face cloth.29,35 However, this method has its limitations, including poor heat retention,36 and inconvenience leading to reduced compliance.29 Over the years, more patient-friendly warm compresses have become available, such as the MGDRx EyeBag® (The EyeBag® Company, Halifax, UK) and the OPTASETM Moist Heat Mask (Scope Ophthalmics Ltd., Dublin, Ireland). While both warm compresses are principally very similar; they are heated in a microwave, and a single heating is required to provide 10 minutes of therapy; there are fundamental differences between them. The OPTASETM Moist Heat Mask contains HydroBeadTM Technology, which absorbs moisture from the air, and when heated, releases it to provide a moist heat. The moist heat therapy helps to soften eyelash debris in patients with anterior blepharitis, and restores moisture to the eye and surrounding area, in conjunction with improving meibum flow, tear film quality and reduced tear film evaporation. By contrast, the MGDRx EyeBag® is filled with flax seed and provides a dry heat when applied to the eyelids. Manufacturers recommend it for relief of, including but not limited to; MGD, blepharitis, dry eye syndrome, and rosacea. Their efficacy in the treatment of Demodex blepharitis has not previously been investigated.
Non‐pharmaceutical treatment options for meibomian gland dysfunction
Published in Clinical and Experimental Optometry, 2020
Reiko Arita, Shima Fukuoka
The simplest approach to warm‐compress therapy is the application of a hot towel. However, this approach has not been standardised for the treatment of MGD, with patients applying the towel for various times at various temperatures and with varying degrees of compliance.2011 One study found that application of a hot towel at 45°C for a total of at least four minutes, with replacement of the towel with a new one at the same temperature every two minutes, resulted in eyelid warming sufficient to melt meibum in individuals with MGD.2008 Such a procedure is probably not realistic for the performance of warm‐compress therapy by patients at home. Although hot towels have been found to be effective for the treatment of MGD, they have also been reported to induce transient visual impairment due to corneal distortion, as evidenced by the polygonal reflex of Fischer‐Schweitzer and that apparently results from the associated application of light pressure.2007 Therapy with a hot towel was found to be not as effective with regard to heat retention compared with microwaveable bags containing beads or wheat.2016 The application of bundled hot towels allows an appropriate temperature to be maintained, although, again, compliance is unlikely to be good.2015
Comparative Evaluation in Intense Pulsed Light Therapy Combined with or without Meibomian Gland Expression for the Treatment of Meibomian Gland Dysfunction
Published in Current Eye Research, 2021
Yiqin Chen, Junhua Li, Yue Wu, Xiaolei Lin, Xiaohui Deng, Zhao Yun-e
Patients were randomly divided into three groups by random number table: (1) MGX group (32 patients, 32 eyes); (2) IPL group (33 patients, 33 eyes), and (3) IPL + MGX group(35 patients, 35 eyes). Only right eyes were included in the study. All patients received three treatments spaced 3 weeks apart. The Lumenis M22 (Lumenis Ltd., Yokneam, Israel) was used for IPL therapy. After adjusting the appropriate parameters according to Fitzpatrick skin classification, IPL was applied across the skin area below the lower eyelid of each eye in two passes.14 The patient’s eyes were fully covered with an eye shield during the procedure. Hot compresses (43°C, 15 min) were performed with a Dy-5 multifunctional low-frequency electronic therapy instrument (Xi’an Huaya Electronic Instrument co., LTD., China). Except for the IPL group, all patients’ meibomian glands were expressed using meibomian tweezers. During the follow-up period after treatment, all subjects were instructed only to use the same formulation of artificial tears (Hycosan; sodium hyaluronate 0.1%, Ursapharm, Arzneimittel GmbH, Saarbrücken, Germany) four times a day. Warm compresses were also recommended three times a day (15 min each time) throughout the follow-up period.
Related Knowledge Centers
- Blepharitis
- Chalazion
- Conjunctivitis
- Meibomian Gland Dysfunction
- Stye
- Ophthalmology
- Dry Eye Syndrome
- Spasm