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Emergency situations requiring immediate attention (call 999 or go to A&E): Severe bleeding from a varicose vein (apply direct pressure and elevate the leg while seeking help) Sudden chest pain, breathlessness, or coughing up blood (possible pulmonary embolism) Urgent assessment needed (same-day GP or urgent care): Sudden onset of leg pain, swelling, warmth, or redness, which could indicate deep vein thrombosis (DVT) Routine referral to vascular services (discuss with GP): Symptomatic varicose veins causing pain, aching, discomfort, swelling, or itching Skin changes near varicose veins (discolouration, thickening, eczema-like rashes) Development of ulcers near varicose veins Superficial vein thrombosis with suspected venous incompetence Active or healed venous leg ulcer Routine monitoring of vein health is advisable, particularly for patients with pre-existing varicose veins or risk factors for venous insufficiency

Gentle swirling or patient waiting is always the correct approach

Have you heard about pancreatitis risk with semaglutide

Kansanen et al., 2013) together with the upstream mediators (dead receptors