Journal of Vascular Nursing RSS feed: Current Issue. Journal of Vascular Nursing provides clinical information regarding aortic and peripheral aneurysms, upper and lower extremity arterial disease, acute and chronic venous disease, and more. Original, peer-reviewed articles present descriptions, etiologies, diagnostic procedures, medical and surgical treatment and nursing implications of vascular system disorders.http://www.jvascnurs.net/?rss=yesElsevier Inc.en © 2009 Society for Vascular Nursing, Inc. Published by Elsevier Inc All rights reserved. Journal of Vascular Nursing1062-0303274December 2009 © 2009 Society for Vascular Nursing, Inc. Published by Elsevier Inc All rights reserved. healthpermissions@elsevier.comhttp://www.jvascnurs.net/article/PIIS1062030309001022/abstract?rss=yes As I reflect back over this year, I am amazed at the numerous care initiatives that we as nurses have led and implemented. Such evidence-based best practice initiatives include VTE protocols, surgical-care improvement programs, elder-care principles, pressure-ulcer programs, catheter-associated urinary tract infection programs, vascular catheter-associated infection programs, patient-safety programs and fall-prevention programs, to name just a few. These initiatives have demonstrated positive effects on patient outcomes. Such initiatives have improved quality of care and have helped our patients lead healthier lives. Certainly, they play a major role in transforming our healthcare system. Nurses have created model programs in acute care, primary care and public health settings that have improved and are continuing to improve the health status of our patients and communities. These initiatives are expanding access, improving quality, promoting prevention, and driving down costs. They have gained recognition from consumer groups, insurers, physicians, states and the federal government.From the Editor's Perspective…10.1016/j.jvn.2009.09.002Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Perspectives9191http://www.jvascnurs.net/article/PIIS1062030309001034/abstract?rss=yesPrevious research has shown that differences exist between men and women in clinicians' perception of some cardiovascular symptoms, such as angina associated with coronary heart disease. However, a gap exists in literature about the potential gender differences in the experience of claudication symptoms related to peripheral arterial disease (PAD). The specific aim of this study was to determine whether differences exist between men and women with PAD in their experience of claudication. A qualitative analysis of a parent study in which men and women with PAD described their claudication symptoms was used to address the objective. In the parent study, open-ended, tape-recorded interviews were conducted with 38 patients (24 men, 14 women) ages 44 to 83 years (mean 65) from 2 United States medical centers during 1996 to 1997 to report patient experience of PAD. In the present study, a content-analysis approach was used to examine these interviews and explore whether different patterns were present in the way men and women describe their claudication symptoms.Four major themes were identified in how patients described their claudication symptoms: (1) symptom descriptions; (2) pathophysiology descriptions; (3) response descriptions; and (4) understanding of disease process. Overall, no striking gender differences in the claudication symptom experience of this subject group were evident. However, some subtle gender differences were identified.Regardless of gender, it is important for clinicians to remember that many different types of claudication symptom descriptions exist. The subtle gender differences in claudication descriptions reported during the interviews could be investigated through further interview sessions with questions developed specifically to elicit information about the claudication experience and possible gender differences in these descriptions. Assessment and care management should expand to include symptom experience beyond classic claudication.Claudication symptom experience in men and women: Is there a difference?Sara Tomczyk, Diane Treat-Jacobson10.1016/j.jvn.2009.09.003Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Articles9297http://www.jvascnurs.net/article/PIIS1062030309001009/abstract?rss=yesStroke in adults under the age of 45 results in a greater loss of potential years of life than for other adults. This premature loss of life is associated with a high social and economic burden. Few data are available regarding stroke among young Nigerian adults in the Niger Delta Basin. This study sought to determine the incidence, risk factors, stroke subtypes and case fatality of stroke among young Nigerian adults. The medical records of all 18- to 45-year-old patients admitted with stroke in the medical wards of the University of Port Harcourt Teaching Hospital (UPTH) from January 2003 to December 2008 were retrospectively reviewed. Of the 611 patients admitted with stroke, 54 (8.8%) were aged 18-45 years. There were 26 males and 28 females. Hypertension was responsible for 42 (77.8%) stroke cases. Other important risk factors were excessive alcohol intake (27.8%), heart disease (13%), diabetes mellitus (11.1%), cigarette smoking (11.1%) and HIV infection (7.4%). The total case fatality was 29.6% with intracerebral hemorrhage (ICH) having higher case fatality of 69.2% than cerebral infarction (CI) with a case fatality of 16.7%. Among the young Nigerian adults who presented with stroke, 53.7% survived. The authors conclude from the above information that the incidence of stroke in young patients at UPTH is low. Hypertension is the most important risk factor of stroke; however, other less common but important risk factors in the young adults are cigarette smoking, diabetes mellitus and HIV. Efforts should be made to reduce the impact of stroke in this age group by focusing on these risk factors, which are either preventable or modifiable.Stroke in young Nigerian adultsA.C. Onwuchekwa, R.C. Onwuchekwa, E.G. Asekomeh10.1016/j.jvn.2009.08.001Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Articles98102http://www.jvascnurs.net/article/PIIS1062030309001046/abstract?rss=yesThe removal of the saphenous veins in coronary artery bypass graft (CABG) surgery may cause leg edema. Compression therapy is often used to prevent postoperative edema. The objective of this study was to compare the efficacy of medical compression stocking (TED) and elastic bandage-type on donor limbs after CABG. The peripheries of lower limbs were measured at four regions (A: end of tarsal bones, H: heel , B: immediately above the ankle, C: largest circumference of the calf) at admission in 295 patients how CABG candidates and differences in these measurement points at discharge compared to measurements at admission time were calculated. The difference was considered as a measure of the effectiveness of two types of compression to prevent postoperative edema in donor limbs after CABG. The alterations of 396 donor limbs of 295 patients were examined after CABG at admission and discharge time. In 101 patients veins for graft were taken from both lower limbs. After analysis, if subjects had worn TED stockings, the peripheries of donor limbs at discharge were less than at admission time in the A and H regions compared to elastic bandage group (PA=0/009), (PH=0/012). The conclusion reached was that using the kind of knee length compression stocking (TED stocking , Kendall Co.) is more effective edema at foot and heel regions in donor limbs after CABG than elastic bandages.Comparison of compression stocking with elastic bandage in reducing postoperative edema in coronary artery bypass graft patientKhoshgoftar Zohreh, Ayat Esfahani Farah, Marzban Mehrab, Salehi Omran Abbas, Hajighasemi Alireza, Movaghar Soraya, Saadat Soheil10.1016/j.jvn.2009.09.004Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Articles103106http://www.jvascnurs.net/article/PIIS1062030309001058/abstract?rss=yesThis articles presents a rare case of accidental insertion of an intravascular catheter into an artery by an experienced nurse (RN). Due to the patient's hypotension, this faulty positioning was misdiagnosed and a potential peripheral ischemic necrosis was, fortunately, avoided only because the anesthesia drug injection was performed through another vein. Clinical signs were also present but were also underestimated. After intra-arterial confirmation of the incorrect position, the catheter was subsequently removed. No further complications were observed.Incidental catheterization of a radical arterial branch during vascular cannulation: A case reportEvangelos A. Konstantinou, Theofanis Fotis, Aristotelis Mitsos, Ioanna Nomikou, Konstantina Mamoura, Athina Karavasopoulou, Maria Bastaki, Theodoros Mariolis-Sapsakos, Konstantinos Zarmakoupis10.1016/j.jvn.2009.09.005Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Articles107108http://www.jvascnurs.net/article/PIIS1062030309001010/abstract?rss=yesThis article examines the use of clinical and genetic data to determine a dose algorithm for each, as well as a combined algorithm for dosing. Data for 4,043 patients were used. Only stable doses, not initial doses were considered. A validation cohort of 1,009 subjects was used to evaluate the clinical value of each of the three algorithms. Dosing ranges evaluated were those of 21mg of warfarin per week or less and those requiring 49mg of warfarin per week or more to achieve the target international normalized ratio (INR).Review of an Article: The international Warfarin Pharmacogenetics Consortium (2009). Estimation of the warfarin dose with clinical and pharmacogenetic data. NEJM 360 (8): 753-64Janice D. Nunnelee10.1016/j.jvn.2009.09.001Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7Research Column109109http://www.jvascnurs.net/article/PIIS1062030309001101/abstract?rss=yesTable of contents10.1016/S1062-0303(09)00110-1Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7FrontmatterA1A1http://www.jvascnurs.net/article/PIIS1062030309001113/abstract?rss=yesInformation for authors10.1016/S1062-0303(09)00111-3Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7FrontmatterA2A3http://www.jvascnurs.net/article/PIIS1062030309001125/abstract?rss=yesInformation for readers10.1016/S1062-0303(09)00112-5Journal of Vascular Nursing 27, 4 (2009)2009-12-01Journal of Vascular Nursing2009-12-01274S1062-0303(09)X0011-7FrontmatterA4A4