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Biomedical subjects

D Duprez

Publications and source records attributed to D Duprez.

133 records · Page 8Linked to original sources
PubMedDate not supplied

Natural history and evolution of peripheral obstructive arterial disease.

The natural history of peripheral arterial occlusive disease is discussed. Severe limb-threatening ischemia is the most serious consequence of chronic arterial occlusive disease. Severe ischemia and amputation can be considered as an endpoint in peripheral vascular disease. Severe limb ischemia is relatively uncommon in isolated aortoiliac disease and this is more than twice in patients with either femoropopliteal or multisegmental disease. Subsequent studies have also demonstrated that both smoking and diabetes are associated with a substantial risk for sudden ischemia. A clear majority of about 50% deaths are caused by associated coronary artery disease, 15% to stroke and 10% to vascular disease in the abdomen. Ankle systolic blood pressure is one of the most significant factors in the progression of peripheral arterial occlusive disease and also for cardiovascular mortality. In the future, men need to know how therapies as exercise, during regimens would influence the most frequent complications besides severe limb ischemia, namely brain infarction and coronary artery disease.

Aged↗
PubMedDate not supplied

[Intermittent claudication of the legs: what can be obtained without pharmacologic agents].

Intermittent claudication of the lower limbs is treated routinely by either drugs, percutaneous transluminal angioplasty, surgery or a combination of these. Each of these therapeutic approaches carries a certain risk; side effects can develop. Moreover, often there is a lack of well controlled studies to evaluate the objective basis of the results. Therefore, in the present paper, evolution of walking distance in patients presenting with intermittent claudication was followed during non-pharmacological treatment mainly consisting of daily muscle training and avoiding to use nicotine.

Chronic Disease↗
PubMedDate not supplied

Ketanserin in intermittent claudication. A double-blind placebo-controlled study.

Twenty patients with intermittent claudication and having an ankle/arm blood pressure ratio less than or equal to 0.75 were randomized to receive ketanserin 40 mg b.i.d. or placebo for three months under double-blind conditions following a six-week run-in period. A placebo was administered for an additional six weeks at the end of the double-blind phase. Results indicated that ketanserin significantly increased (p less than 0.04) the pain-free walking distance by 36% versus a non-significant 10% rise with placebo. During the run-out period, this parameter remained significantly increased (p less than 0.04) with ketanserin. Changes in the total walking distance during the double-blind period were 15% and 11% for ketanserin and placebo, respectively, with a significant (p less than 0.05) increase to 30% occurring in the ketanserin group during the run-out phase. There was a decrease in the ankle/arm blood pressure ratio in the worst leg in both groups. The rise of systemic blood pressure after exercise was attenuated with ketanserin. Side-effects were reported in only one patient in the placebo group. These data indicate that ketanserin may be of value in patients suffering from intermittent claudication. Other studies are, however, warranted to determine whether this beneficial effect is general or restricted to a subgroup of patients.

Aged↗
PubMedDate not supplied

Localisation and risk factors of peripheral arterial occlusive disease in the female.

Peripheral arterial occlusive disease has been described frequently as a disease affecting predominantly men. There is only a few information available concerning peripheral vascular disease in the female. Therefore, the aim of the present study was to examine risk factors in relation to localisation and symptoms of peripheral arterial occlusive disease in female patients. A retrospective study has been performed in 48 female patients (52-82 years with a mean age 69.5 years). Finally 45 patients were witheld because they had all a doppler examination and an oscillography of the lower limbs. The majority of the patients, namely 22 patients (49%) had combined ileofemoral and distal lesions. There were 15 patients (33%) who had isolated distal lesions, while only 8 patients (18%) had isolated ileofemoral vascular lesions. With respect to the symptoms the population could be divided in three groups: 16 patients (36%) were asymptomatic, 19 patients (42%) had intermittent claudication and 10 patients (22%) had rest pain and necrosis. Smoking was not the predominant risk factor in this group. Diabetes mellitus seemed to enhance distal vascular lesions, while arterial hypertension, obesity and lipids were predictive risk factors in peripheral vascular disease in the female. A high incidence of cardiovascular disease (31 patients, 69%) and cerebrovascular disease (13 patients, 29%) was concomitant.

Aged↗
PubMedDate not supplied

Diagnostic performance of the bidirectional Doppler velocity curve recorded at the ankle.

The diagnostic value of different parameters derived from the Doppler velocity curve recorded at the ankle was analysed in a population of 432 subjects. To document the presence or absence of obliterative arterial diseases in the lower limbs, systolic blood pressure measurements were made and oscillography before and after exercise was recorded. A descending slope below 20.5 mm as recorded during 0.40 sec, appears as a sensitive indicator of occlusive arterial diseases of the lower extremities: 84% of the limbs were correctly classified showing with a high sensitivity of 91.8% but a lower specificity of 76%. By considering a combination of two parameters (descending slope and crest-time), the overall performance increases up to 88% and specificity becomes satisfactory (85%), while sensitivity is kept at 90%. Quantitative analysis of the Doppler velocity curve recorded at the ankle is feasible and is most helpful in discriminating normal and abnormal limbs both in daily clinical practice and in large scale studies.

Adolescent↗
PubMedDate not supplied

Comparison between ankle and toe index in patients with peripheral arterial disease.

In contrast to the systolic blood pressure at the posterior tibial artery, the evaluation of pressure at the digital artery of the foot before and after exercise in patients with peripheral arterial disease is not well known. Twenty three patients with peripheral vascular disease were examined. The systolic pressure was measured by means of an ultrasound velocity detector at the brachial and posterior tibial artery. Digital artery pressure was determined with photoplethysmography. Pressures were measured before and within 5 and 10 minutes after a treadmill test. Ankle and toe index was calculated. At rest the toe index is lower than the ankle index and after a treadmill test the decrease in toe index occurs in parallel to the ankle index.

Ankle↗