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At least 811 records · Page 45Linked to original sources
PubMed1998

Outcome of collagen vascular diseases by treatment with plasmapheresis.

The outcome of collagen vascular diseases after treatment with plasmapheresis was studied in 9 patients with polyarteritis nodosa (PN), in 2 patients with Wegener's granulomatosis (WG), in 1 patient with allergic granulomatous angitis (AGA), and in 20 patients with systemic lupus erythematosus (SLE) associated with antiphospholipid syndrome (APS). Improvement after treatment with plasmapheresis was observed in 41.7% of the patients with PN, WG, and AGA. On the other hand, with the exception of 1 patient with thrombocytopenia and 1 patient with renal failure, all of the clinical manifestations, including thrombocytopenia, central nervous system (CNS) lupus, thrombophlebitis, lung infarction, and recurrent abortions in the SLE patients with APS, improved after plasmapheresis. Plasmapheresis is thought to be an influential strategy of treatment for patients with collagen vascular diseases.

Adult↗
PubMed2004

Radiology of pulmonary vascular disease.

Diagnostic radiology plays an important role in the evaluation of suspected pulmonary vascular disease. This article discusses the use of various radiographic modalities and the radiographic features of several pulmonary vascular diseases.

Diagnostic Imaging↗
PubMed1998

Left ventricular long axis disturbances as predictors for thallium perfusion defects in patients with known peripheral vascular disease.

OBJECTIVE: To compare resting long axis echocardiography with adenosine thallium-201 emission tomography in detecting myocardial ischaemic abnormalities in patients before peripheral vascular surgery. DESIGN: A prospective and blinded preoperative examination of resting left ventricular minor and long axes and myocardial perfusion during adenosine vasodilatation using thallium-201 emission tomography. SETTING: A tertiary referral centre for cardiac and vascular disease equipped with invasive, non-invasive, and surgical facilities. SUBJECTS: 65 patients (40 men) with significant peripheral vascular disease, mean (SD) age 63 (10) years, and 21 control subjects of similar age. METHODS: Segments were classified as normal, with fixed or reversible defects according to thallium-201 myocardial perfusion tomography. Systolic long axis abnormalities were either reduced excursion and/or abnormal shortening after A2, and diastolic abnormalities either delayed onset of lengthening > 80 ms and/or reduced peak lengthening rate < 4.5 cm/s. Segmental perfusion defects were compared with the equivalent long axes; anteroseptal for septal, inferoseptal for posterior, and lateral for left side giving a total of 195 segments. RESULTS: Systolic long axis abnormalities predicted fixed thallium defects (sensitivity 86%, specificity 87%, positive predictive value 0.78, negative predictive value 0.93, p < 0.001), and diastolic abnormalities correlated with reversible perfusion defects (sensitivity 90%, specificity 85%, positive predictive value 0.72, negative predictive value 0.95, p < 0.001). Echocardiography characteristics of the true and false positive segments were not different in the site or the extent of abnormalities. CONCLUSION: Systolic long axis abnormalities predict fixed and diastolic reversible thallium perfusion defects in patients with peripheral vascular disease. Ventricular long axis may thus have a value as a screening test before peripheral vascular surgery as well as providing a means of monitoring myocardial perfusion. The high negative predictive values indicate that a negative long axis study makes significant perfusion abnormalities very unlikely in patients with high pretest probability of coronary artery disease.

Adenosine↗
PubMed2002

Regulation of transforming growth factor-beta signaling and vascular diseases.

PURPOSE: Members of the transforming growth factor (TGF)-beta superfamily play critical roles in regulation of various cellular functions. Dysregulation of the signaling mechanisms of the TGF-beta superfamily proteins is associated with clinical diseases such as cancer, fibrotic diseases, and vascular disorders. Therefore, understanding these signaling mechanisms may provide us with novel ways to develop strategies for treating clinical diseases induced by these cytokines. METHODS: This review discusses our current understanding of the mechanisms of TGF-beta signaling, focusing on the roles of TGF-beta in regulation of vascular wall cells and on the regulation of TGF-beta superfamily signals by inhibitory Smads.

Bone Morphogenetic Proteins↗
PubMed1985

Laser treatment for retinal vascular diseases.

To obtain a clinically adequate laser lesion one must adjust four variables, namely treatment spot size, duration of application, wavelength, and power. The intensity of the necessary reaction will depend upon the type of disease and lesion being treated. When retinal vascular diseases are treated using the laser, the pattern of laser lesions is determined by the morphology, type, and distribution of the retinal vascular disease. This pattern varies from focal and multifocal direct treatment to ablative techniques from one to four quadrants and maximally four quadrants and treatment within the temporal retinal vascular arcades usually avoiding treatment within the papillomacular bundle.

Aneurysm↗
PubMed1987

Patterns of oxygen consumption during exercise testing in peripheral vascular disease.

Exercise testing on a treadmill was performed in 15 patients with peripheral vascular disease to determine the pattern of oxygen consumption during exercise. A plateau in the oxygen consumption over the final 90 s of exercise was used as a criterion for maximal effort and only 4 out of 15 (27%) obtained a plateau of oxygen consumption compared to 20 out of 26 (77%) normal subjects (chi 2 7.9, p less than 0.005). These findings may account for the limited value of exercise testing in detecting coronary artery disease in patients with peripheral vascular disease.

Adult↗
PubMed1976

Mustard operation and creation of ventricular septal defect in two patients with transposition of the great arteries, intact ventricular septum and pulmonary vascular disease.

The condition of patients with transposition of the great arteries, intact ventricular septum and severe pulmonary vascular disease is inoperable with present techniques. In a series of 260 surgically treated patients with transposition of the great arteries and intact ventricular spetum, 5 had severely increased pulmonary vascular resistance, and all 5 died; postmortem examination confirmed the presence of severe pulmonary vascular disease. The concept of the "palliative Mustard" procedure was applied in two children with transposition of the great arteries, intact ventricular spetum and pulmonary vascular disease who underwent the Mustard operation with creation of a ventricular septal defect. The postoperative course was uneventful in both patients. Thirteen and 5 months, respectively, after operation, both are physically active and have respective arterial oxygen saturation levels of 94 and 92 percent.

Aneurysm↗
PubMedDate not supplied

[Double aortic puncture: a new technique for the investigation of multiple vascular disease (author's transl)].

A new technique for the investigation of multiple vascular disease is described. This involves double aortic puncture conducted successively during the same operation time. The author emphasizes the precautions to be taken in relation to the original technique described by Amplatz, and the essential procedures that must be observed during the injection of large volumes of contrast medium. This technique enables the complete investigtions of multiple vascular disease to be conducted without the risks involved when using Seldinger's method.

Aortography↗
PubMed2003

Urological manifestations of vascular disease.

We have detailed several of the urological manifestations of vascular disease. With the aging of the North American population, urologists will encounter the urological complications of vascular disease with ever-increasing frequency.

Acute Kidney Injury↗
PubMed2003

Living with peripheral vascular disease: a review of the literature.

Peripheral vascular disease is a debilitating condition that can significantly reduce a patient's quality of life. It affects mainly older people and causes severe chronic pain that can make even simple activities of daily living impossible. This paper reviews the literature on the management of PVD, with specific emphasis on the patient experience of living with the condition.

Activities of Daily Living↗
PubMed1997

Effects of increased ICAM-1 on reperfusion injury and chronic graft vascular disease.

BACKGROUND: The purpose of this study was to assess the impact of increased donor cardiac intercellular adhesion molecule (ICAM-1) expression on both reperfusion injury and chronic graft vascular disease after transplantation. METHODS: Hearts were harvested from donor rats before and after pretreatment with lipopolysaccharide at -24 hours, underwent 45 minutes of cold ischemia, and were transplanted into ACI recipients with or without anti-ICAM-1 monoclonal antibody treatment. Grafts were procured early for analysis of ICAM-1 expression and reperfusion injury or the recipients were treated with cyclosporin A (to allow long-term graft acceptance) for postoperative days 0 through 9 with procurement on postoperative day 90 to histologically score for chronic graft vascular disease. RESULTS: Lipopolysaccharide-pretreated PVG heart grafts showed increased ICAM-1 expression by Northern blot and immunohistochemical analysis leading to increased reperfusion injury as assessed by neutrophil infiltration (myeloperoxidase), cardiac edema (percentage wet weight), and histologic injury (percentage area of contraction band necrosis), which was reversed by recipient treatment with anti-ICAM-1 monoclonal antibody. After administration of cyclosporin A, 5 mg/kg for 10 days, lipopolysaccharide-treated grafts had significantly worse chronic graft vascular disease scores (2.56 +/- 0.57 versus 1.84 +/- 0.75; p < 0.05 by Mann-Whitney U test). CONCLUSIONS: The induction donor inflammatory state before harvest leading to increased cardiac ICAM-1 expression promotes reperfusion injury and chronic graft vascular disease after transplantation in this rodent heterotopic heart model.

Animals↗
PubMed1995

[Pulmonary involvement of collagen vascular diseases: studies on prognostic factors from basic and clinical viewpoints].

In 715 patients with collagen vascular diseases, interstitial lung disease and pulmonary hypertension were found to be important causes of death (37.5% and 6%, respectively). The prognosis of interstitial lung disease associated with collagen vascular disease was better than that of idiopathic interstitial pneumonia; patients with the latter were more likely to experience exacerbations. A distinct subgroup of patients with dermatomyositis and interstitial lung disease with a rapidly progressive course was characterized by mild muscle symptoms, low levels of creatine phosphokinase and negative tests for anti-Jo-1 antibody. CT scores and analysis of bronchoalveolar lavage fluid proved to be of some value in predicting outcome. Measurement of IL-6 in bronchoalveolar lavage fluid and local immunostaining for this pro-inflammatory cytokine were helpful in evaluating responses to therapy.

Antibodies, Antinuclear↗
PubMed2003

Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography.

OBJECTIVE: The purpose of this study was to determine the accuracy of CT angiography using a multidetector scanner in the evaluation of patients with peripheral vascular disease. SUBJECTS AND METHODS: Eighteen patients with peripheral vascular disease who were referred for elective digital subtraction angiography (DSA) also underwent CT angiography. We scanned patients from the level of the superior mesenteric artery to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection reconstructions. Findings were graded according to six categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (75-99% stenosis); 5, occluded; and 6, nondiagnostic. CT angiography findings were compared with DSA findings for each arterial segment. RESULTS: We found agreement for the degree of stenosis in 77.7% of the arteries and discrepancy for 22.3% of the arteries when all categories were considered. Grouping the six categories according to the threshold for treatment (categories 1 and 2 as one group and categories 3, 4, and 5 as the second group) resulted in an agreement of 91.95%. Compared with DSA, CT angiography yielded a sensitivity of 90.9% and a specificity of 92.4%. CONCLUSION: Multidetector CT angiography is an accurate, noninvasive technique for the imaging of peripheral vascular disease.

Aged↗
PubMed1991

Prevalence of abdominal aortic aneurysm in patients with occlusive peripheral vascular disease.

Over a 1-year period, 242 patients with peripheral vascular disease underwent abdominal ultrasonography to detect the presence of an abdominal aortic aneurysm. In 34 (14 per cent) an abdominal aortic aneurysm was found; half of these aneurysms were greater than 4 cm in diameter. In addition, 16 patients had ectatic aortas. Abdominal aortic aneurysms were more common in men than in women (17 versus 8 per cent). Patients with claudication were as likely to have an abdominal aortic aneurysm as those with rest pain or gangrene. The presence of aortoiliac occlusive disease increased the chance of an aneurysm being present (P less than 0.02). Patients with occlusive peripheral vascular disease are a high-risk group with regard to the development of an abdominal aortic aneurysm. Patients with proximal occlusive disease represent a subgroup at even higher risk.

Adult↗
PubMed1984

Whole blood and red cell ATP content in patients with peripheral vascular disease: the effect of cigarette smoking and oxpentifylline.

The relationship between erythrocyte ATP content and the presence of atherosclerotic peripheral occlusive vascular disease was investigated. In 20 elderly patients with severe peripheral vascular insufficiency (10 male, 10 female; age 68.8 +/- 12.5 years; Mean +/- SD) the mean erythrocyte ATP content was 1.57 +/- 0.16 mmol/litre. In a sex and age matched group (69.1 +/- 9.6 years) with no signs or symptoms of peripheral or myocardial ischaemia, erythrocyte ATP content did not differ significantly (1.49 +/- 0.29 mmol/litre). In young healthy volunteers, there was no difference in erythrocyte ATP content between males and females or between cigarette smokers and non-smokers, nor were the values for the young group different from those obtained from the elderly patients. The effect of oxpentifylline administration on erythrocyte ATP levels in patients with peripheral vascular disease was also studied. Administration of oxpentifylline (1.6 g per day in divided doses) over 7 days had no effect on erythrocyte ATP content in 10 patients (5 male, 5 female) with ischaemic lower limbs. These results suggest that measurement of erythrocyte ATP content is unlikely to be a useful index in the assessment of peripheral vascular disease.

Adenosine Triphosphate↗
PubMed1993

Ocular vascular disease: in-office primary care diagnosis.

Central retinal artery occlusion occurs most commonly between the ages of 50 and 70 years, and nearly one-half (45%) of patients also have carotid artery disease. Other causes of vision-threatening vascular disease include atherosclerosis, embolism, hypertension, diabetes mellitus, and valvular disease. Symptoms vary, depending on the ocular structures involved. The patient's symptoms are an important clue to the diagnosis of peripheral or posterior retinal vascular occlusion, macular blood vessel disease, intravitreal hemorrhage, optic nerve ischemia, and ocular ischemic syndrome. The patient's ocular symptoms should lead to investigation for clinical signs of ocular vascular disease (eg, hemorrhage, "hard" or "soft" exudates, neovascularization, retinal edema, pallor, emboli, vessel narrowing, or atriovenous crossing changes).

Aged↗
PubMed2002

Atherosclerotic vascular disease in systemic lupus erythematosus.

In the United States, systemic lupus erythematosus (SLE) disproportionately affects African Americans. It has become a chronic disease with long-term morbidity including chronic renal disease, osteoporosis, cataracts, psychosocial impairment, and importantly, atherosclerotic vascular disease (ASVD). The latter (myocardial infarction, angina, peripheral vascular disease and stroke) are strikingly accelerated, occurring in subjects who are predominantly premenopausal women at an age when ASVD is rare or unusual. Although much is known about the biology, risk factors, and the prevention of atherosclerosis in normal individuals, little work has been done in SLE. In fact, ASVD in people with SLE may be a different disease. Approximately 1.5% of SLE patients per year will have a myocardial infarction or equivalent; about 0.5% of SLE patients per year will have a stroke. The risk factors for ASVD in SLE are based on small, retrospective, single center studies. These suggest that the risk factors known for the general population (i.e., smoking, obesity, sedentary lifestyle, high LDL cholesterol, etc.) are also observed in SLE. The best study of risk factors shows that even accounting for the known factors, SLE and/or its treatment (glucocorticoids) is by far the most important. Our current management of cardiovascular risk factors in SLE patients with ASVD is substandard and our adherence to national guidelines for prevention is substandard. It is not known whether improving either will prevent these disastrous outcomes. Very little is known about the risk factors in African Americans with SLE, although there is data to suggest that they may not be identical to those seen in Caucasian populations. The study of the best and most effective means to prevent ASVD in SLE and in African Americans with SLE and in African Americans with SLE should be a major priority.

Black or African American↗