Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “VASCULAR DISEASES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 937 records · Page 52Linked to original sources
PubMed2003

Atherosclerotic ischemic renal vascular disease: do published outcomes justify the overzealous diagnostic approaches?

Atherosclerotic renal vascular disease is being recognized more frequently in an elderly patient population with chronic kidney disease. It also is much easier to diagnose and treat, at this time, because of the wide availability of coronary angiography and other radiologic imaging studies. In general, patients with atherosclerotic ischemic renal vascular disease are much sicker than the usual ESRD patient with more cardiac comorbidity and higher mortality rates. It is important to determine whether the lesions in the renal artery are physiologically significant before performing an intervention. The interventions are often risky with significant morbidity. Nephrologists should guide their colleagues to follow prudent courses of action. There are no evidence-based guidelines in this area.

Arteriosclerosis↗
PubMed1989

[Pulmonary hypertension and pulmonary vascular disease in congenital heart defects].

Pulmonary vascular disease (PVD) is a serious complication of several congenital heart defects (CHD). The post-tricuspid heart lesions, such as AVSD, VSD, PDA, TGA with VSD, Ao-pulmonary window, Truncus arteriosus, DORV and DILV (univentricular heart) with a high pressure and increased flow in the pulmonary circulation are earlier and more often the cause of PVD than such pretricuspid shunts as ASD or TAPVD. The pathogenesis of PVD is only partially known. The endothelial cell of the pre- and intraacinar arteries releases substances (eicosanoids and mitogens) which cause functional and structural changes in the wall of arteriols and precapillary arteries: media hypertrophy, intima proliferation, obliterations, and necroses. The number and size of small arteries is reduced. Advanced changes are irreversible. Subtle diagnostic tools are necessary to evaluate the clinical, hemodynamic and morphologic status of the pulmonary circulation. Clinical signs, ECG, echocardiogram, x-ray of the chest, cardiac catheterization and special angiograms of the lung vessels have to be performed and their results have to be viewed in a synopsis. The type of tapering of the small arteries in the wedge-angio, the transit time of contrast media in the digital function angio, and changes of pressure and flow under test conditions give further information. Biopsy and histologic studies are difficult and not without risk. Treatment means prevention of advanced changes of PVD. Earlier correction of operable defects, banding of the pulmonary artery in complex heart lesions can avoid the development of PVD. A potent dilator of the small pulmonary arteries, applicable orally and over a long time, is not available at present.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1984

[Combination of arterial and venous vascular diseases].

The coincidence of arterial and venous vascular diseases in the region of the extremities is demonstrated. The frequency and the pathophysiological connections are explained and a subdivision of the different forms of combination is made. The therapy has to orient itself at the pathophysiological processes of the individual case, where the arterial as well as the venous vascular region is to be included in the treatment.

Angiography↗
PubMed1986

Renal transplantation in diabetes mellitus. Influence of preexisting vascular disease on outcome.

We reviewed the recommendations and outcomes for all patients with diabetes mellitus and end-stage renal disease referred to the Medical Center Hospital of Vermont from 1971 through December 1983. During this period, we recommended transplantation in 53 of 73 patients evaluated. Thirty-two transplants were performed in 30 patients. Of the 30 patients, 10 had clinical vascular disease prior to transplantation, i.e., claudication, amputation, active angina, myocardial infarction, or stroke. Seven of the 10 had only claudication or amputation. These 10 patients showed a clear excess in graft failure and mortality. One- and 2-year graft survival was 37 and 13%; patient survival was 48 and 24%. By comparison, the 20 patients without evident vascular disease had 1- and 2-year graft survival rates of 83 and 75% and patient survival rates of 85% at both 1 and 2 years. The incidence of cardiovascular death in the group with vascular disease was 45% at 1 year and 63% at 2 years, as compared with none in the group without vascular disease. The high graft loss and mortality in this group after transplantation should be a major consideration when therapeutic alternatives are considered in diabetics with end-stage renal disease.

Adult↗
PubMed1998

The epidemiology and cost of inpatient care for peripheral vascular disease, infection, neuropathy, and ulceration in diabetes.

OBJECTIVE: To describe the epidemiology and costs of the acute care of peripheral vascular disease, infection, neuropathy, and ulceration in a U.K. population with special consideration of those patients with diabetes. RESEARCH DESIGN AND METHODS: Routine data describing inpatient care for a 4-year period were analyzed (financial years 1991/1992 to 1994/1995). These data had undergone record-linkage to draw together records from the same patients, and records of patients with diabetes were flagged. Cost estimates were determined by attributing a diagnosis-related group cost-weight to each record. RESULTS: A total of 4,245 admissions (1.2% of all admissions) had a primary diagnosis of peripheral vascular disease, infection, neuropathy, or ulceration, and 7,379 (2.1%) admissions had these categories recorded in any one of six diagnostic fields. These figures were generated by 3,159 and 4,751 patients, respectively. This represented a range of crude annual incidence of admission of between 1.9 and 2.9 per 1,000 people. Patients with diabetes accounted for 625 (15.4%) of primary admissions, a crude annual incidence of admission of 18.8 per 1,000. The age-standardized relative risk of admission for patients with diabetes to the nondiabetic population was 7.61 for men and 6.85 for women. The length of stay for patients with diabetes was almost twice that of the nondiabetic population (15.5 vs. 8.7 days). The relative risk of hospital mortality (diabetes vs. non-diabetes) was 2.83. Surgical procedures were carried out on 857 patients, 272 (31.2%) with diabetes. This represented an age-standardized relative risk of 31.19. The estimated cost of admissions for primary diagnoses in these categories over 4 years was 6,128,211 pounds ($9,743,855). Patients with diabetes accounted for 1,236,623 pounds ($1,966,230), an excess of 87% attributable to the diabetic state. CONCLUSIONS: Diabetes is confirmed as a significant risk factor for peripheral vascular disease, infection, neuropathy, and ulceration. The severity of these disorders in terms of increased risk of hospital mortality, length of stay, and risk of surgical procedure is also demonstrated for those patients with diabetes.

Communicable Diseases↗
PubMed1981

Symptomatic exacerbation of peripheral vascular disease with chronic ambulatory peritoneal dialysis.

Details of five patients with exacerbation of the symptoms of peripheral vascular disease on chronic ambulatory peritoneal dialysis (CAPD) are presented. The mechanisms of their vascular complications are discussed and the peripheral arterial sequelae of hypotension induced by CAPD are emphasized. These patients are compared with the other patients in the series of 121 patients. Suggestions for diagnosis and treatment of exacerbations of peripheral vascular disease in patients on CAPD are given.

Arteriosclerosis↗
PubMedDate not supplied

Resting plasma fibrinolytic activity and fibrinolytic potential in peripheral vascular disease.

Reduced plasma fibrinolytic activity may be a risk factor in venous and arterial thrombotic disease. Resting plasma fibrinolytic activity and fibrinolytic potential after ten minutes of venous occlusion were compared in 100 patients with peripheral vascular disease of varying severity and 20 age-sex matched controls. The fibrinolytic assay used was the euglobulin lysis time. Resting plasma fibrinolytic activity was significantly reduced in patients with a recent arterial thrombosis (p = 0.02) and ischaemic rest pain (p = 0.008) compared with controls. Fibrinolytic potential after venous occlusion was significantly reduced also in patients with a recent arterial thrombosis (p = 0.02) and ischaemic rest pain (p = 0.05) compared with controls. There were no significant differences between patients with claudication and controls. A reduced plasma fibrinolytic activity has been confirmed in patients with peripheral vascular disease and fibrinolytic potential may be a superior method of assessment as the euglobulin lysis time after venous occlusion is independent of the fibrinogen concentration. It remains uncertain whether the finding of reduced plasma fibrinolytic activity in patients with peripheral vascular disease is cause or effect and whether the finding has prognostic significance.

Aged↗
PubMed1996

Peripheral vascular disease in spinal cord injury patients: a difficult diagnosis.

The timely detection of peripheral vascular disease (PVD) in spinal cord injury (SCI) patients is difficult because the usual symptoms of claudication and rest pain are absent. In fact, the initial manifestation of PVD in SCI patients is often advanced gangrene, so that healing, primarily or following major amputation, is either difficult and prolonged or impossible. In addition, sacral and ischial pressure sores common among SCI patients may be exacerbated and reconstruction made more difficult by PVD. Five SCI patients presented with lower extremity gangrene as the initial recognized manifestation of PVD at our institution between January 1992 and January 1994. All 5 patients had risk factors for PVD. Four out of ten limbs in these patients required amputation, either above the knee or below the knee. Three patients required concurrent vascular reconstruction of the aortoiliac segments, including an aortobiprofunda femoral bypass, an iliac embolectomy with femoral-femoral bypass, and iliac angioplasty. Three patients had ischial and/or sacral pressure sores that had recurred following multiple musculocutaneous flap reconstructions before vascular disease was recognized. The timely diagnosis of PVD involving the iliac segment in the SCI patient is sometimes overlooked and is often necessary to optimize the treatment of both lower extremity ulcers and sacral/ ischial pressure sores common among these patients.

Adult↗
PubMed2004

Sunflower oil does not protect against LDL oxidation as virgin olive oil does in patients with peripheral vascular disease.

BACKGROUND & AIMS: The aim of this study was to compare the in vivo effects of a diet rich in virgin olive oil or sunflower oil on the lipid profile and on LDL susceptibility to oxidative modification in free-living Spanish male patients with peripheral vascular disease. METHODS: A total of 20 Spanish male subjects diagnosed with peripheral vascular disease were randomly divided into two groups (n = 10) receiving different supplements, virgin olive oil and sunflower oil for 4 months. RESULTS: The adaptation of patients to the experimental supplements was demonstrated since plasma and LDL fatty acids composition reflected dietary fatty acids. No differences in triglycerides, total cholesterol, LDL-cholesterol or HDL-cholesterol concentrations were found between the groups of patients. A significantly higher LDL susceptibility to oxidation was observed after sunflower oil intake in comparison with virgin olive oil, in spite of an increase in LDL alpha-tocopherol concentration in sunflower oil group. CONCLUSIONS: The results of the present study provide further evidence that sunflower-oil-enriched diets does not protect LDL against oxidation as virgin olive oil does in patients with peripheral vascular disease.

Aged↗
PubMed1999

Impact of apolipoprotein E epsilon4 and vascular disease on brain morphology in men from the NHLBI twin study.

BACKGROUND AND PURPOSE: Apolipoprotein E epsilon4 genotype (ApoE4) has been associated with increased risk for cardiovascular disease morbidity or mortality. This appears to be mediated by an ApoE4-related increase in cardiovascular atherosclerosis. Given the similarities between risk factors for heart disease and risk factors for stroke, a positive association between ApoE4 and stroke would be expected. Since age-related brain atrophy and the extent of white matter hyperintensities (WMH) share similar risk factors, we examined the combined effect of ApoE4 and history of vascular disease on brain volume, WMH, and MRI evidence of stroke. METHODS: Subjects were the surviving members of the National Heart, Lung, and Blood Institute Twin Study. This is a longitudinal study of the effects of cardiovascular disease risk factors in community-dwelling male veterans. The fourth and final examination of this cohort included cerebral MRI and was completed in 1997. Apolipoprotein E (ApoE) genotype, quantitative measures of brain volume, WMH, and the presence of stroke on MRI were obtained from the 396 participants in the final examination. The presence or absence of a history of coronary heart disease, cerebrovascular disease, peripheral arterial disease, and ApoE genotype were determined for each subject. RESULTS: Of the 396 men, 88 (22%) had at least 1 ApoE4 allele. ApoE4 was not associated with differences in age or education. While the prevalence of vascular disease was generally greater in the ApoE4 group, this was only significant for coronary heart disease (29.8% in subjects without ApoE4 versus 40.7% in subject with ApoE4; P=0.03). ApoE4 subjects had significantly smaller brain volumes (942.4+/-34.5 versus 952.2+/-40.1 cm(3); P=0. 02). MRI evidence of stroke was detected in 88 (22%) of the subjects. The distribution of ApoE genotype was marginally different between subjects with MRI-detected stroke compared with those without. Further analysis revealed that the co-occurrence of cerebrovascular disease and ApoE4 was associated with significantly greater brain atrophy and WMH than either ApoE4 or cerebrovascular disease alone. Similar relations were seen for coronary heart disease and peripheral arterial disease. CONCLUSIONS: We conclude that ApoE4 enhances the extent of brain abnormalities in the presence of various vascular diseases. We speculate that this effect may be mediated by an increased susceptibility to brain injury or impaired repair mechanisms associated with ApoE4.

Adult↗
PubMed1986

Psychosocial considerations in peripheral vascular disease. Cause or effect?

Psychosocial factors play an important role in the development of peripheral vascular disease. The disease can also have profound effects on a client's psychosocial systems. This article emphasizes the importance of obtaining specific information about these systems and suggests methods of psychosocial evaluation to use during the nursing assessment of clients with peripheral vascular disease.

Aging↗