The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition. Skin care is crucial in preventing skin breakdown and venous ulcers. Eczematous (stasis) dermatitis buy VX-770 can be managed with emollients and topical steroid creams. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule
out pelvic or thigh proximal venous thrombosis or compression. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Brawny, nonpitting skin with edema characterizes lymphedem. a, which can present in one or both lower extremities. Possible
secondary causes of lymphedema include tumor, trauma, previous pelvic BI 6727 datasheet surgery, inguinal lymphadenectomy, and previous radiation therapy. Use of pneumatic compression devices or compression stockings may be helpful in these cases. (Am Fam Physician. 2013;88(2):102-110. Copyright (C) 2013 American Academy of Family Physicians.)”
“Objectives: To collect reasons for selecting the methods for meta-analysis of diagnostic accuracy from authors of systematic reviews and improve guidance on recommended methods.
Study Design and Setting: Online survey in authors of recently published meta-analyses see more of diagnostic accuracy.
Results: We identified 100 eligible reviews, of which 40 had used more advanced methods of meta-analysis (hierarchical random-effects approach), 52 more traditional methods (summary receiver operating characteristic curve based on linear regression or a univariate approach), and 8 combined both. Fifty-nine authors responded to the survey; 29 (49%) authors had used advanced
methods, 25 (42%) authors traditional methods, and 5 (9%) authors combined traditional and advanced methods. Most authors who had used advanced methods reported to do so because they believed that these methods are currently recommended (n = 27; 93%). Most authors who had used traditional methods also reported to do so because they believed that these methods are currently recommended (11 = 18; 75%) or easy to understand (n = 18; 75%).
Conclusion: Although more advanced methods for meta-analysis are recommended by The Cochrane Collaboration, both authors using these methods and those using more traditional methods responded that the methods they used were currently recommended. Clearer and more widespread dissemination of guidelines on recommended methods for meta-analysis of test accuracy data is needed. (c) 2013 Elsevier Inc. All rights reserved.