Background: Venous leg ulcers (VLUs) affect 1-3% of the population and impose substantial pain-related morbidity, yet vascular pain remains underrecognized in clinical practice and research. Objectives: This narrative review synthesizes current evidence on the pathophysiology, clinical manifestations, and management strategies for VLU-associated pain. Methods: A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Embase, and Web of Science (January 2015-July 2025) following SANRA guidelines. Search terms included "vascular pain", "venous leg ulcer", "chronic venous disease" and related terminology. Studies addressing pathophysiology, clinical characteristics, diagnostic approaches, and therapeutic interventions were included. Results: VLU pain demonstrates complex pathophysiology encompassing nociceptive, neuropathic, and nociplastic components driven by venous hypertension, chronic inflammation, and central sensitization. Pain prevalence ranges from 50-87% in VLU patients, significantly impacting quality of life and functional status. Evidence supports a five-strategy management framework: (1) treating underlying venous pathology through early ablation, (2) optimized compression therapy achieving ~40 mmHg ankle interface pressure, (3) procedure-specific local anesthesia using topical agents, (4) multimodal systemic analgesia targeting neuropathic features, and (5) adjunctive venoactive drugs. Patient-reported outcome measures reveal substantial psychosocial burden beyond wound-related symptoms. Conclusion: VLU pain represents a distinct clinical entity requiring mechanism-based, multidisciplinary approaches. Early venous intervention, evidence-based compression protocols, and targeted analgesic strategies show promise for improving outcomes. Critical research gaps include dedicated pain-focused clinical trials, standardized outcome measures, and personalized treatment algorithms. Enhanced recognition and systematic management of vascular pain could substantially improve patient-centered outcomes in chronic venous disease.
Many letters and theses written on the subject of consensus, as well as in measurement,
But we tried to address a topic of consensus
Building a blind measuring guide.
We have tried to explain the meaning of convening, then the statement of consensus in language and terminology and then the statement of measurement
Also, we have shown the types of consensus mentioned by the jurists, and this is how much was in the first topic, either
The second section included the statement of the doctrines of the blind in the matter, and then the evidence of each doctrine and discussed.
We followed it with the most correct opinion statement and concluded the research with some of the conclusions we reached through
search.
This comprehensive review examines the efficacy and safety of tumor necrosis factor-alpha (TNF-α) inhibitors in treating various autoimmune diseases, and focuses on their application in Iraqi patients. Elevated TNF-α levels are linked to autoimmune disorders, leading to the development of anti-TNF-α therapies such as infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab, which have gained FDA approval for conditions like psoriasis, in¬flammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis. While these therapies demonstrate sig¬nificant therapeutic benefits, including improved quality of life and disease management, they also carry risks, such as increased susceptibility to infections and pote
... Show MoreIntroduction. The coexistence of non-small cell lung cancer (NSCLC) and chronic obstructive pulmonary disease (COPD) is commonly observed, primarily due to overlapping risk factors like smoking and environmental exposures. This dual diagnosis introduces complex clinical scenarios, often associated with worsened outcomes and heightened vulnerability to treatment-related side effects. Immune checkpoint inhibitors, especially atezolizumab, have emerged as pivotal agents in enhancing clinical outcomes for individuals diagnosed with NSCLC. Recent evidence suggests that atezolizumab remains effective and well-tolerated in NSCLC patients with coexisting COPD. This review evaluates the efficacy and safety of atezolizumab in NSCLC patients with coex
... Show MoreA review of comparative analytical methods for β-lactam antibiotics and heavy metals in pharmaceutical products and human biological matrices
CD40 is a type 1 transmembrane protein composed of 277 amino acids, and it belongs to the tumor necrosis factor receptor (TNFR) superfamily. It is expressed in a variety of cell types, including normal B cells, macrophages, dendritic cells, and endothelial cells, as a costimulatory molecule. This study aims to summarize the CD40 polymorphism effect and its susceptibility to immune-related disorders. The CD40 gene polymorphisms showed a significant association with different immune-related disorders and act as a risk factor for increased susceptibility to these diseases.
Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa