Biomedical subjects

A D Kester

Publications and source records attributed to A D Kester.

At least 19 recordsLinked to original sources

PubMed2006

Breath condenser coatings affect measurement of biomarkers in exhaled breath condensate.

Exhaled breath condensate collection is not yet standardised and biomarker measurements are often close to lower detection limits. In the current study, it was hypothesised that adhesive properties of different condenser coatings interfere with measurements of eicosanoids and proteins in breath condensate. In vitro, condensate was derived from a collection model using two test solutions (8-isoprostane and albumin) and five condenser coatings (silicone, glass, aluminium, polypropylene and Teflon). In vivo, condensate was collected using these five coatings and the EcoScreen condenser to measure 8-isoprostane, and three coatings (silicone, glass, EcoScreen) to measure albumin. In vitro, silicone and glass coatings had significantly higher albumin recovery compared with the other coatings. A similar trend was observed for 8-isoprostane recovery. In vivo, median (interquartile range) 8-isoprostane concentrations were significantly higher using silicone (9.2 (18.8) pg.mL(-1)) or glass (3.0 (4.5) pg.mL(-1)) coating, compared with aluminium (0.5 (2.4) pg.mL(-1)), polypropylene (0.5 (0.5) pg.mL(-1)), Teflon (0.5 (0.0) pg.mL(-1)), and EcoScreen (0.5 (2.0) pg.mL(-1)). Albumin in vivo was mainly detectable using glass coating. In conclusion, a condenser with silicone or glass coating is more efficient for measurement of 8-isoprostane or albumin in exhaled breath condensate, than EcoScreen, aluminium, polypropylene or Teflon. Guidelines for exhaled breath condensate standardisation should include the most valid condenser coating to measure a specific biomarker.

Adolescent↗

PubMed2003

Physical activity levels in children and adolescents.

BACKGROUND: Reference data for physical activity level (PAL) and activity-related energy expenditure (AEE) are needed for a better understanding of the effect of activity on childhood health, growth and development OBJECTIVE: Data from 17 studies measuring TDEE (TDEE) with doubly labelled water DLW were combined to construct a reference line for PAL and AEE as a function of age. DESIGN: A total of 17 studies from the literature were analyzed; 17 on girls and 16 on boys. Children were aged 3-16 y and of Caucasian origin. Weighted least-squares regression was used to obtain reference lines for PAL and AEE as a function of age and gender. The relative numbers of children per study were used as a weighting factor. Basal metabolic rate (BMR) or nonfasted (NF) resting metabolic rate and sex were included in the analysis. RESULTS: Although there was no difference in PAL between boys and girls, a significant difference in AEE was found between the two sexes. PAL: 0.025 x age+1.40. AEE (MJ/day): boys 0.30 x age+0.025; girls 0.21 x age+0.33. If BMR is measured under NF conditions, the obtained value has to be reduced by 0.21 for PAL and 0.75 MJ/day for AEE. No relation was found between AEE/kg and age. CONCLUSIONS: PAL and AEE were found to increase with age, showing the importance of age-dependent recommendations. Recommendations for AEE need to be differentiated for sex. To compare PAL and AEE between studies, the measurement conditions of BMR have to be taken into account. The increase in PAL and AEE values can be attributed to an increase in weight, because there was no relation between AEE/kg and age.

Adolescent↗

PubMed2003

Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection.

BACKGROUND: Diagnostic tests enabling general practitioners (GPs) to differentiate rapidly between pneumonia and other lower respiratory tract infections (LRTIs) are needed to prevent increase of bacterial resistance by unjustified antibiotic prescribing. AIMS: To assess the diagnostic value of symptoms, signs, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) for pneumonia; to derive a prediction rule for the presence of pneumonia; and to identify a low-risk group of patients who do not require antibiotic treatment. DESIGN OF STUDY: Cross-sectional. SETTING: Fifteen GP surgeries in the southern part of The Netherlands. METHOD: Twenty-five GPs recorded clinical information and diagnosis in 246 adult patients presenting with LRTI. Venous blood samples for CRP and ESR were taken and chest radiographs (reference standard) were made. Odds ratios, describing the relationships between discrete diagnostic variables and reference standard (pneumonia or no pneumonia) were calculated. Receiver operating characteristic analysis of ESR, CRP, and final models for pneumonia was performed. Prediction rules for pneumonia were derived from multiple logistic regression analysis. RESULTS: Dry cough, diarrhoea, and a recorded temperature of > or = 38 degrees C were independent and statistically significant predictors of pneumonia, whereas abnormal pulmonary auscultation and clinical diagnosis of pneumonia by the GPs were not. ESR and CRP had higher diagnostic odds ratios than any of the symptoms and signs. Adding CRP to the final 'symptoms and signs' model significantly increased the probability of correct diagnosis. Applying a prediction rule for low-risk patients, including a CRP of < 20, 80 of the 193 antibiotic prescriptions could have been prevented with a maximum risk of 2.5% of missing a pneumonia case. CONCLUSION: Most symptoms and signs traditionally associated with pneumonia are not predictive of pneumonia in general practice. The prediction rule for low-risk patients presented here, including a CRP of < 20, can considerably reduce unjustified antibiotic prescribing.

Adolescent↗

PubMed2001

Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: a longitudinal study.

The current study describes the age- and sex-specific incidence rates and risk factors for asymptomatic and symptomatic peripheral arterial occlusive disease (PAOD) among 2,327 subjects and the incidence of intermittent claudication in asymptomatic PAOD subjects. The study population was selected from 18 general practice centers in the Netherlands. PAOD was assessed with the ankle-brachial blood pressure index, and intermittent claudication was assessed with a modified version of the Rose questionnaire. After 7.2 years, the overall incidence rate for asymptomatic PAOD, using the person-years method, was 9.9 (95% confidence interval (CI): 7.3, 18.8) per 1,000 person-years at risk. The rate was 7.8 (95% CI: 4.9, 20.3) for men and 12.4 (95% CI: 7.7, 24.8) for women. For symptomatic PAOD, the incidence rate was 1.0 (95% CI: 0.7, 7.5) overall, 0.4 (95% CI: 0.3, 10.0) for men, and 1.8 (95% CI: 1.0, 10.3) for women. Multivariate analyses showed that increasing age, smoking, hypertension, and diabetes mellitus were the most important risk factors. The overall incidence rate for intermittent claudication among PAOD subjects who were asymptomatic at baseline was 90.5 per 1,000 person-years at risk (95% CI: 36.4, 378.3). The incidence of asymptomatic PAOD was higher than the incidence of symptomatic PAOD, with women developing PAOD more often than men. In the development of preventive strategies, modification of atherosclerotic risk factors, such as smoking, hypertension, and diabetes, should be the main goals.

Adult↗

PubMed2001

Modulation of rat platelet activation by vessel wall-derived prostaglandin and platelet-derived thromboxane: effects of dietary fish oil on thromboxane-prostaglandin balance.

By dietary manipulation of rats with n-3 polyunsaturated fatty acids (PUFAs), platelets and endothelium-containing aortic tissue were obtained with decreased levels of arachidonate and increased levels of eicosapentaenoate and docosahexaenoate. These diet-induced changes were accompanied by a reduced formation of thromboxane A(2) (TXA(2)) and prostaglandin I(2) (PGI(2)) in platelets and aortic tissue, respectively. When platelets were incubated with autologous, aorta-derived PGI(2), the dietary modulation of PGI(2) generation had a stronger effect on the activation process than the dietary effect on TXA(2) generation. The platelet-inhibiting effect of PGI(2) was independent of the type of agonist and involved both TXA(2)-dependent and -independent activation responses. PGI(2) also inhibited the agonist-induced formation of TXA(2). In addition, the platelet-inhibitory effect of PGI(2) was more prolonged in time than the brief, stimulatory effect of TXA(2). We conclude that, in the thromboxane-prostaglandin balance of platelet activation, PGI(2) plays a more prominent role than TXA(2). Furthermore, dietary n-3 PUFAs appear to influence platelet activation more by reducing formation of endothelial PGI(2) than by decreasing autocrine-produced TXA(2). Thus, in rats, the proposed antithrombotic effect of fish oil is unlikely to be caused by an altered thromboxane-prostaglandin balance.

Animals↗

PubMed2001

Changes in pulmonary hyperinflation and bronchial hyperresponsiveness following treatment with lansoprazole in children with cystic fibrosis.

SUMMARY. In this prospective open study of 14 children with cystic fibrosis (CF), we evaluated the effect of 1 year adjuvant therapy with lansoprazole, a proton pump inhibitor (PPI), on growth, fecal fat loss, body composition and lung function. Only stable patients with pancreatic insufficiency were included, and their data were compared to those of a large Dutch pediatric normal reference population. During the use of the PPI, mean weight and height did not change significantly, while body mass index improved (P < 0.05). An immediate significant and persistent reduction of fecal acid steatocrit (P < 0.05) was demonstrated. Compared to normal Dutch children, the CF patients showed significantly decreased standard deviation scores (SDS) for total body fat (TBF, -0.966) and fat-free mass (FFM, -1.826). Under lansoprazole, TBF improved significantly (P < 0.05), while mean FFM remained unchanged. A significant improvement in total lung capacity (P < 0.05), residual volume (P = 0.055), and maximal inspiratory mouth pressure (P = 0.002) was also demonstrated. Hyperinflation tended to decrease during the use of a PPI. Daily recordings of peak expiratory flow (PEF) showed a maximal diurnal variability of 28% of recent best PEF and minimal morning PEF of 72% of recent best PEF, confirming that bronchial hyperresponsiveness is increased in CF. We conclude that adjuvant therapy with lansoprazole in young CF patients with persistent fat malabsorption, decreased fat losses and improved total body fat. Lung hyperinflation decreased, which may partly explain the improvement in inspiratory muscle performance. The simultaneous improvements in body composition and lung hyperinflation suggest a relationship between these two parameters. Further research is necessary to confirm such a relationship and to elucidate the mechanisms involved.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2001

Validation of a computerized metabolic measurement system (Oxycon-Pro) during low and high intensity exercise.

The aim of the study was to validate a new, fast metabolic measurement system (the Oxycon-Pro) during low and high exercise intensities against the Douglas bag method. For this purpose twelve highly trained subjects performed an incremental cycle ergometer test. In the third minute of each exercise step simultaneous measurements of the Douglas bag and the Oxycon-Pro were performed. No significant differences between the Oxycon-Pro and the Douglas bag measurements for minute ventilation (VE), oxygen uptake (VO2) and carbon dioxide expiration (VCO2) were found. Bland and Altman analysis of validity demonstrated minimal bias and low standard deviations. In conclusion, the results show that the Oxycon-Pro is a valid apparatus for determination of minute ventilation (VE), oxygen uptake (VO2) and carbon dioxide expiration (VCO2) during low as well as during maximal exercise intensities. Unlike with the Douglas bag method, this fast metabolic measurement system can be used for accurate and quick determination of ventilatory variables during exercise.

Adult↗

PubMed2001

Body composition in Prader-Willi syndrome compared with nonsyndromal obesity: Relationship to physical activity and growth hormone function.

OBJECTIVE: To study the relationship of fat mass, extracellular-to-intracellular-water ratio, and bone mineral density with growth hormone function and physical activity in Prader-Willi syndrome. STUDY DESIGN: There were 17 patients with PWS (10 women, ages 7.5-19.8 years) and 17 obese control patients, matched for gender and bone age. FM and extracellular-to-intracellular-water ratio were measured by bromide-deuterium dilution, BMD by dual-energy x-ray absorptiometry, GH function by fasted serum insulin-like growth factor-I concentration, and physical activity by doubly-labeled water in combination with basal metabolic rate by a ventilated hood. RESULTS: The PWS group had a similar fat mass, but a lower fat-free mass, whereas the extracellular-to-intracellular-water ratio was higher compared with the control group (0.87 +/- 0.07 l/l and 0.80 +/- 0.06 l/l, respectively [P <.01]). Fat mass was inversely related with PA in the PWS group, whereas IGF-I was positively correlated with FFM, ICW, and BMD of the limbs. BMD tended to be lower in patients with PWS. CONCLUSIONS: In children and adolescents with PWS, adiposity is associated with a reduced fat-free mass and extracellular-to-intracellular-water ratio is increased. Both findings are related to GH function and physical activity. BMD, especially in the limbs, tends to be reduced in patients with PWS and is related to GH function.

Adolescent↗

PubMed2001

Essential fatty acid composition of plasma phospholipids and birth weight: a study in term neonates.

BACKGROUND: Essential fatty acids (EFAs) in umbilical cord blood samples are associated with attained birth weight in premature infants and low-birth-weight neonates. OBJECTIVE: The objective was to investigate relations between the EFA composition of cord and maternal plasma phospholipids and birth weight in term neonates. DESIGN: This was a cross-sectional study in 627 singletons born at term. The plasma phospholipid EFA composition of the mothers was determined by gas-liquid chromatography at study entry (< or = 16 wk gestation), at delivery, and in cord plasma at birth. Birth weights were normalized to SD scores. RESULTS: In cord plasma, the dihomo-gamma-linolenic acid concentration was positively related to weight SD scores. Both arachidonic acid (AA) and docosahexaenoic acid (DHA) were negatively related to weight SD scores. EFA-status indicators showed similar negative associations, whereas eicosatrienoic acid concentrations were positively related to neonatal size. In maternal plasma, proportions of n-3 long-chain polyenes (LCPs) and n-6 LCPs decreased during pregnancy. Larger decreases in AA, DHA, n-3 LCP, and n-6 LCP fractions were observed in mothers of heavier babies. Higher concentrations of LCPs in maternal plasma were, however, not related to a larger infant size at birth. CONCLUSIONS: A lower biochemical EFA status in umbilical cord plasma and a larger decrease in maternal plasma LCP concentrations are associated with a higher weight-for-gestational-age at birth in term neonates. Our findings do not support a growth-stimulating effect of AA or DHA; however, they do suggest that maternal-to-fetal transfer of EFAs might be a limiting factor in determining neonatal EFA status.

8,11,14-Eicosatrienoic Acid↗

PubMed2001

Energy metabolism in relation to body composition and gender in adolescents.

OBJECTIVE: To study the effect of body composition on average daily metabolic rate (ADMR) and basal metabolic rate (BMR) in adolescence, and to examine current BMR prediction equations. STUDY: Dutch adolescents were pooled with previously reported American and British subjects (n = 90 overall). BMR and ADMR were analysed by multiple regression. RESULTS: Fat-free mass, BMR, and ADMR were higher in the obese than in the non-obese group (mean (SD): 53.2 (10.7) kg, 8.35 (1.57) MJ/d, and 13.64 (2.78) MJ/d, compared with 41.0 (8.1) kg, 6.42 (0.94) MJ/d, and 11.16 (2.21) MJ/d, respectively). BMR remained higher when adjusted for fat-free mass, age, and sex. ADMR adjusted for BMR was similar in the two groups. WHO equations overestimated BMR in obese boys and underestimated BMR in non-obese boys. CONCLUSIONS: BMR, but not activity, is increased in obese adolescents and in male adolescents. The WHO BMR equations for adults are recommended for obese adolescents.

Adolescent↗

PubMed2001

Dose dependent increased mortality risk in COPD patients treated with oral glucocorticoids.

Systemic corticosteroids are often administered in COPD patients. The relationship between systemic glucocorticoids and mortality in patients with moderate to severe chronic obstructive pulmonary disease (COPD) was retrospectively analysed. Baseline characteristics of the patients, in stable clinical condition, were collected on admission to a pulmonary rehabilitation centre. Overall mortality was asessed at the end of follow-up. The Cox proportional hazards model was used to quantify the relationship between glucocorticoid use, distinguishing administration route (oral/inhalation) and oral dose, and overall mortality, adjusted for the influence of age, sex, smoking, lung function, resting arterial blood gases and body mass index. On multivariate analysis, oral glucocorticoid use at a (prednisone equivalent) dose of 10 mg x day(-1) without inhaled glucocorticoids, was associated with an increased risk (RR=2.34, 95% confidence interval (CI) 1.24-4.44) while 15 mg x day(-1) carried a relative risk of 4.03, CI = 1.99-8.15). A significant interaction was observed between inhaled and oral glucocorticoid use. Combined with inhaled glucocorticoids, the relative risk of oral glucocorticoid use appeared to be significantly smaller. It is concluded that in severe chronic obstructive pulmonary disease, maintenance treatment with oral glucocorticoids is associated with increased mortality in a dose-dependent manner. Since the present study design cannot exclude the possibility of bias by indication, further prospective studies are indicated using a broader patient characterization.

Administration, Oral↗

PubMed2000

[Limited changes in prescription of third-generation oral contraceptives after reports on elevated thrombosis risk and subsequent professional guidelines].

OBJECTIVE: To compare the prescription behaviour of general practitioners (GP) and gynaecologists regarding 2nd and 3rd generation oral contraceptives (OC) in the period before and after the warning of increased thrombosis risk of 3rd generation pills. DESIGN: Retrospective, descriptive. METHOD: With the aid of data on OC prescriptions collected by the Institute for Medical Statistics, the numbers of prescriptions from Dutch GPs and gynaecologists in the year before the warning by the British Committee on Safety of Medicines that 3rd-generation OC increased the risk of thrombosis, were compared with the numbers in the year after publication of the guideline of the Dutch General Practitioners Society (NHG), which stated a preference for the 2nd-generation OC, and of the guideline of the Dutch Society for Gynaecology and Obstetrics, which stated no preference. RESULTS: In neither the GP nor the gynaecologist groups did the proportion of 3rd-generation pills in the OC prescriptions decrease significantly. However, in the GP group the proportion of new 3rd generation OC prescriptions decreased significantly from 56 to 40%. However, after a few trimesters it rose again. CONCLUSION: The changes in prescription behaviour of the GP group were in accordance with the NHG guidelines. However, the proportion of the 3rd-generation OC prescriptions remained relatively large and the effect was of short duration. The only conclusion that could be drawn regarding the gynaecologists, was that the proportion of 3rd-generation OC prescriptions did not change significantly.

Contraceptives, Oral↗

PubMed2000

Activity related energy expenditure in children and adolescents with Prader-Willi syndrome.

OBJECTIVE: To measure activity related energy expenditure in Prader-Willi syndrome (PWS) corrected for body size. SUBJECTS: 17 PWS subjects (10 females, seven males, age 7.5-19.8 y) and 17 obese controls, matched for gender and bone age. MEAUREMENTS: Basal metabolic rate (BMR) was measured by ventilated hood and average daily metabolic rate (ADMR) was measured with doubly labelled water. Activity induced energy expenditure (AEE) was calculated as 0.9ADMR -BMR. Activity related energy expenditure was corrected for body size using the following measures: AEE per kg body weight (AEE/kg), ADMR/BMR (PAL), and the residual of the regression of ADMR on BMR (rADMR). Group differences were analyzed by analysis of covariance adjusting for bone age, fat mass (FM) and gender. RESULTS: ADMR, AEE and PAL were lower (P < 0.01) in the PWS group compared with the control group (7.14 +/- 1.72, 1.07 +/- 0.69 and 1.33 +/- 0.15 MJ/day compared with 9.94 +/- 2.64, 2.56 +/- 1.03 and 1.55 +/- 0.12 MJ/day respectively). The variance of AEE/kg and PAL was significantly explained by gender and PWS, while AEE was additionally explained by FM. The variance of rADMR was explained by PWS and not by FM or gender. CONCLUSION: Activity related energy expenditure is decreased in PWS compared with controls adjusted for bone age, FM and gender.

Adolescent↗

PubMed2000

Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss.

AIM: To identify risk factors for early nonelective readmission in patients with chronic obstructive pulmonary disease, previously admitted for an exacerbation of their disease. Clinical characteristics were analysed with special emphasis on body weight on admission and weight changes during hospitalization. METHODS: The computerized hospital database was used to select all hospital admissions in 1994 and 1995 with exacerbation of chronic obstructive pulmonary disease as main discharge diagnosis. Cases were retained if they were nonselectively readmitted within 14 days after prior discharge, and if they had no oedema. Controls were randomly selected from the discharge listing and were not readmitted within 3 months. Cases and controls were matched on several parameters including FEV(1)% predicted obtained during a stable phase of the disease. Hospital charts were reviewed for clinical parameters on admission, discharge and readmission. RESULTS: Fourteen cases were retained in the study. On admission, lung function, blood gases and parameters describing morbidity and social factors, were not different in cases and controls. The discharge procedure was adequate. During hospitalization the cases lost weight (mean+/-SD) (-1.6+/-1.9 kg, P= 0.01), while controls remained weight stable. Using a matched pairs logistic regression analysis, weight loss during hospitalization (P= 0.011) and low BMI on admission (P= 0. 046) were related to the increased risk of unplanned readmission. CONCLUSION: These findings provide further support for the concept that nutritional status is related to morbidity in COPD.

Aged↗

PubMed2000

Energy expenditure at rest and during sleep in children with Prader-Willi syndrome is explained by body composition.

BACKGROUND: Obesity in Prader-Willi syndrome (PWS) seems to be related to a low basal metabolic rate (BMR). In addition, abnormal sleep patterns reported in PWS might affect sleeping metabolic rate (SMR). OBJECTIVE: Our objective was to assess BMR and SMR adjusted for fat-free mass in young PWS patients. DESIGN: Subjects were 17 PWS patients (10 females and 7 males aged 7.5-19.8 y) and 17 obese control subjects matched for sex and bone age. SMR was measured in a respiratory chamber, BMR with a ventilated-hood system, and body composition by deuterium dilution. RESULTS: BMR and SMR were significantly lower in the PWS group than in the control group (5.36 +/- 1.18 and 4.62 +/- 1.08 MJ/d compared with 6.38 +/- 1.55 and 5.60 +/- 1.52 MJ/d, respectively; P < 0.05). When fat-free mass was included in the analysis, multiple regression showed no differences in BMR and SMR between groups. When weight was included in the analysis instead of fat-free mass, SMR was lower in the PWS group. Fat-free mass was lower in the PWS group both as an absolute value and when adjusted for height. CONCLUSION: BMR and SMR are low in young patients with PWS because of a low fat-free mass.

Adolescent↗

PubMed1999

Lack of effectiveness of bed rest for sciatica.

BACKGROUND AND METHODS: Bed rest is widely advocated for sciatica, but its effectiveness has not been established. To study the effectiveness of bed rest in patients with a lumbosacral radicular syndrome of sufficient severity to justify treatment with bed rest for two weeks, we randomly assigned 183 subjects to either bed rest or watchful waiting for this period. The primary outcome measures were the investigator's and patient's global assessments of improvement after 2 and 12 weeks, and the secondary outcome measures were changes in functional status and in pain scores (after 2, 3, and 12 weeks), absenteeism from work, and the need for surgical intervention. Neither the investigators who assessed the outcomes nor those involved in data entry and analysis were aware of the patients' treatment assignments. RESULTS: After two weeks, 64 of the 92 patients in the bed-rest group (70 percent) reported improvement, as compared with 59 of the 91 patients in the control (watchful-waiting) group (65 percent) (adjusted odds ratio for improvement in the bed-rest group, 1.2; 95 percent confidence interval, 0.6 to 2.3). After 12 weeks, 87 percent of the patients in both groups reported improvement. The results of assessments of the intensity of pain, the bothersomeness of symptoms, and functional status revealed no significant differences between the two groups. The extent of absenteeism from work and rates of surgical intervention were similar in the two groups. CONCLUSIONS: Among patients with symptoms and signs of a lumbosacral radicular syndrome, bed rest is not a more effective therapy than watchful waiting.

Absenteeism↗

PubMed1999

The influence of experience on the reproducibility of the ankle-brachial systolic pressure ratio in peripheral arterial occlusive disease.

OBJECTIVES: to estimate the intra-observer variability of the measurement of the ankle-brachial systolic pressure index (ABPI) and to compare the reproducibility of the measurements by experienced vascular laboratory assistants and by less-experienced general practice personnel. DESIGN: repeated measurement of ABPI by general practitioners (GPs), GP-assistants and vascular laboratory assistants using a pocket Doppler device and a random-zero sphygmomanometer. METHODS AND MATERIALS: ABPI was measured in six patients with various degrees of PAOD by two experienced observers (vascular laboratory assistants) and by 24 less-experienced observers (18 practice assistants, six GPs). RESULTS: the total number of measurements was 354. The overall intra-observer variability estimate was 11.8% ABPI. The intra-observer variability was 7.3% in the experienced observers and 12.0% in the less-experienced observers. The difference of variability between experienced and less-experienced observers was significant. CONCLUSIONS: the ABPI is suitable in follow-up studies where repeated measurements are needed. Differences between measurements can be minimised by performing repeated measurements or by using more experienced observers.

Aged↗

PubMed1998

Risk factors and cardiovascular diseases associated with asymptomatic peripheral arterial occlusive disease. The Limburg PAOD Study. Peripheral Arterial Occlusive Disease.

OBJECTIVES: To describe the risk-factor profile and cardiovascular comorbidity of asymptomatic peripheral arterial occlusive disease (PAOD). DESIGN: A cross-sectional survey. Asymptomatic PAOD was defined as an ankle-brachial pressure index < 0.95, measured on two consecutive occasions, without intermittent claudication. Logistic regression analyses were performed to investigate independent associations between age, gender, smoking status, hypertension, obesity, diabetes, hypercholesterolaemia, physical activity, a family history of cardiovascular disease, the occurrence of ischaemic heart disease and cerebrovascular disease (CeVD) and asymptomatic PAOD. SETTING: 18 general practices in the province of Limburg, the Netherlands. SUBJECTS: A total of 3650 subjects, aged 40-78 years. MAIN RESULTS: Asymptomatic PAOD was present in 8.6% (n = 314) and symptomatic disease in 3.8% (n = 138) of the participants. Age, smoking status, hypertension, and diabetes were significantly associated with asymptomatic PAOD. The ratio of asymptomatic to symptomatic PAOD was higher among the younger age groups. Male gender, hypertension and smoking status were stronger associated with symptomatic PAOD compared with asymptomatic PAOD. Asymptomatic subjects had more IHD and CeVD comorbidity compared with the healthy population. CONCLUSION: Our findings suggest that the risk-factor profile and cardiovascular comorbidity of asymptomatic subjects is comparable to claudicants. Preventive efforts could be made to diminish the influence of especially smoking, diabetes and hypertension in asymptomatic subjects.

Adult↗