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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Based on the methods of the Brain Stroke Register, a study was made of epidemiology and risk factors (RF) of ischemic brain stroke (IBS) in one of the cities of the Middle Ob region, numbering 220 thousand population. Based on 615 cases of IBS, a noticeable rise of the disease incidence was revealed in a group of subjects aged 40-49 years as was a high level of the morbidity and mortality among persons over 60 years. Studies into RF discovered a high portion of arterial hypertension (75.1%), atherosclerosis (44.3%), aggravated heredity (28.6%), coronary heart disease (27.9%), alcohol abuse (17.9%). In 90.8% of cases, IBS developed in the presence of unfavorable fluctuations in atmospheric pressure, relative humidity, temperature, and the rate of air movement.
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PMID:[Epidemiology and risk factors of ischemic stroke in the Middle Ob region]. 166 85

Thrombotic occlusion is the major cause of myocardial infarction (MI), and fibrin accumulation appears to play a significant role in development of atherosclerotic lesions. Any factor that reduces the lysis of fibrin may thus increase the risk of MI, and it has been suggested that this accounts for the atherogenicity of the lipoprotein variant Lp(a). The characteristic feature of Lp(a) is an apoprotein which is homologous with part of the plasminogen molecule, and experiments in vitro suggest that it interferes with uptake and activation of plasminogen on cell surfaces and fibrin. The presence of Lp(a) also seemed to offer an explanation for the apparent absence of plasminogen from 70-80% of intimal samples. We have compared the levels of Lp(a) and plasminogen in normal intima and atherosclerotic lesions. In aortic intima there was no relation between Lp(a) and plasminogen, which was absent in some samples with no Lp(a), and present in others with high levels. In intravascular thrombi plasminogen was present at a rather constant concentration (16.3 +/- 4.6 micrograms/100 mg wet tissue), whereas Lp(a) varied over a 100 fold range (0-104 micrograms/100 mg). Plasminogen binds to fibrin and is activated on the fibrin clot, so levels in extracts may not fully represent Lp(a)/plasminogen interactions. After extraction the residual tissues and thrombi were treated with 1 M epsilon-aminocaproic acid (epsilon-aca) to elute lysine-bound components. Lp(a) was eluted from all but one intimal sample, confirming previous findings on its binding to fibrin in lesions, but there was no relation between the amounts of Lp(a) and plasminogen in the tissue eluates. Paradoxically, in the thrombi there was a weak positive correlation between Lp(a) and plasminogen in epsilon-aca eluates (r = 0.504, P = 0.05). These results do not support the hypothesis that Lp(a) displaces plasminogen in vivo, but the large amount of Lp(a) eluted by epsilon-aca suggests that its atherogenicity resides in preferential binding to fibrin, leading to increased lipid accumulation in lesions.
Atherosclerosis 1991 Aug
PMID:Does lipoprotein(a) (Lp(a)) complete with plasminogen in human atherosclerotic lesions and thrombi? 183 24

Clostridial bacteremia is rare and has a variable presentation from asymptomatic to septic shock with disseminated intravascular coagulation (DIC), red cell hemolysis, and rapid death. In order to delineate the predisposing and prognostic factors in these patients, the authors reviewed 47 cases of clostridial bacteremia presenting over a seven year period at a major metropolitan teaching hospital. Predisposing factors included locally decreased oxidation reduction potential (Eh) in 43 per cent (including atherosclerosis, diabetes, and radiation therapy), systemic immunosuppression in 53 per cent (including alcohol abuse, chemotherapy, steroids, and malignancy), and a site of epithelial barrier disruption. The sites of clostridial invasion included: gastrointestinal tract (GI) (n = 22), pulmonary (n = 7), cutaneous (n = 7), undetermined (n = 7), and female genital tract (n = 4). Seven patients were found to have malignancy. Seventy-nine per cent of the blood culture isolates were histotoxic species (Clostridia perfringens and C. septicum). The overall mortality was 47 per cent. Significant differences between survivors and deaths included DIC, new onset renal failure, severe atherosclerotic disease, and age (P less than .05). The authors conclude that clostridial bacteremia is uncommon but highly lethal and may occur when decreased tissue Eh, systemic immunosuppression, and an epithelial barrier disruption are present. Poor outcome appears to be a reflection of advanced age, underlying illness, and presence of a histotoxic species.
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PMID:Clostridial bacteremia: implications for the surgeon. 204 53

In the past years several studies have confirmed the causal role of the three major risk factors, i.e. hypercholesterolemia, hypertension and cigarette smoking in the determination of atherosclerosis and its major complication, coronary heart disease (CHD). In particular the Lipid Research Clinics Primary Prevention Trial and, more recently, the Helsinki Heart Study, have demonstrated beyond doubt the effectiveness of dietary and pharmacological intervention in subjects affected by hypercholesterolemia. The mounting alertness derived from the results of these and other trials has generated the need for "codifying" strategies directed towards the prevention of CHD in the industrialized western world. The population strategy tends to modify cultural and environmental habits such as diet, cigarette smoking, alcohol abuse, physical exercise etc. The individual strategy is directed at identifying, within each population, those individuals who are probably carriers of a particular risk factor, for instance those affected by hyperlipidemia of genetic origin. The two strategies are intended to be two complementary moments in the ceaseless fight against CHD.
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PMID:[New trends in the prevention of ischemic heart disease]. 270 23

In this summary, the authors have attempted to examine reports of associations between various dietary habits and practices on one hand, and serum lipids or clinical disease on the other hand. There seems to be little doubt that both hypertension and ischemic heart disease have a nutritional background, but in all likelihood, there are other factors such as hereditary traits, occupational hazards, and perhaps personal habits including cigarette smoking, alcohol abuse and prolonged ingestion of medicinal drugs. One of the strongest correlates seems to be the role of complex carbohydrates in regulating blood lipid concentrations. Carbohydrates not only have an effect on the endocrine system that regulates blood volume, but they also influence absorption of fat soluble substances from the digestive tract and if natural fiber is included, it has an effect on fecal bulk, transit time of the fecal stream, and reabsorption of bile acids and neutral sterols. Epidemiologically, there is some evidence that the changes that occurred in the American diet in the years between 1914-1944 may well have played a permissive role in the genesis of a portion of the coronary heart disease, high blood pressure and stroke that occurred in the United States. It is not too farfetched to suggest that had the American servicemen been given more cereal food products including bread and other baked food items, instead of excessive amounts of meat and fats, the dietary pattern of America might well have been substantially different. Furthermore, this difference could easily have influenced the pattern of atherosclerosis and hypertension. A great deal more work is needed to confirm or refute these suggestions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dietary changes and their possible effect on blood pressure. 298 49

On the basis of the data from the registry of cerebral stroke (CS) cases in Novosibirsk (covering 937 patients and 314 healthy control subjects) the authors have made a mathematical analysis of 19 factors of the risk of disease development. Nine factors have been isolated whose varying combinations were most contributory to the risk of the development of CS in the studied population: cardiac diseases, transient disorder of the cerebral circulation, arterial hypertension, atherosclerosis, aggravated heredity for cardiovascular diseases, intermittent claudication, diabetes mellitus, systematic alcohol abuse, and hypodynamia. The authors have developed a practicable and reliable system for predicting the development of cerebral stroke in apparently healthy subjects (the accuracy of prediction is 86%).
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PMID:[Experience of prognosis and the risk factors of stroke in Novosibirsk]. 336 95

This review expands information concerning the bilateral below-knee (BK) amputee, describing the findings of a retrospective assessment of 80 such patients. Factors evaluated included etiology, associated conditions, time between amputations, late revisions, use of prostheses, and survival. In 63 patients both amputations were because of atherosclerosis. Of these patients, 86% were diabetic and 84% hypertensive. Peak incidence of the second amputation was during the 7th decade. Average time between amputations was 23 months. Forty-five (71%) of the atherosclerotic patients achieved some functional use of bilateral prostheses. The five patients employed at the time of the second amputation returned to work using prostheses. Average survival after the second amputation was 44 months for those deceased, and 64 months for those alive at the end of the study period. Nine patients had amputations because of various forms of injury, including one for sequential developments due to alcohol-related sensory loss. Eight of this group had a diagnosis of alcohol abuse of psychosis. Reasons for amputations included frostbite, burns, suicide attempt and sensory loss. Five achieved long-term but generally suboptimal prostheses use. The findings support the impression that most atherosclerotic bilateral BK amputees can use prostheses and that their survival and low rate of late stump revisions justify restorative efforts. Mental status was the major determinant of amputation and prostheses use among the non-atherosclerotic patients; discharge from psychiatric hospitals without adequate community support systems was probably contributory. Management and prevention require close collaboration between the rehabilitation, surgical, psychosocial, and public health disciplines.
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PMID:Bilateral below-knee amputations: experience with 80 patients. 395 77

Central nervous system (CNS) infarcts were present at autopsy in 10 of 23 alcoholic patients and in 9 of 36 nonalcoholic patients. There were more males than expected in the infarct population and in the alcoholic population. Male subjects comprised the entire population of alcoholics with infarcts. In addition, a history of alcohol abuse was present in every case of cerebral infarction dying before age 75. The incidence of cardiomegaly was increased among the alcoholics. There were no differences between alcoholics and nonalcoholics in the incidence of diagnosed hypertension, moderate-to-severe coronary atherosclerosis, or adult onset diabetes. However, CNS infarction was more likely to occur at an earlier age in alcoholics than in nonalcoholics. Excessive alcohol consumption may be a risk factor in the premature development of cerebrovascular disease in males.
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PMID:Association of cerebral infarction and chronic alcoholism: an autopsy study. 703 Jan 9

Lysosomes are involved in atherogenesis. Therefore we have studied the level of serum beta-hexosaminidase isoenzymes (Hex A and Hex B) in relation to risk factors for atherosclerosis in a homogeneous population of 886 post-menopausal women. We found a relation with several risk factors such as serum triglycerides, diastolic and systolic blood pressure, blood glucose, waist/hip ratio and body mass index but not with serum cholesterol. Also, the mean values for Hex A and Hex B were higher in smokers than in non-smokers but only the mean value for Hex A differed significantly. The relation of serum beta-hexosaminidase isoenzymes to risk factors might be due to lysosomal over-loading, which gives rise to increased enzyme synthesis and enhanced secretion of lysosomal enzymes to circulation. The subjects in the 95-100 percentile of Hex A showed significantly increased frequency of myocardial infarction of their fathers and of stroke in their mothers and the subjects in the 95-100 percentile of Hex B showed increased frequency of stroke in their mothers. Thus the findings of a relation between Hex isoenzymes and heredity for vascular disease further stress the significant relation between Hex isoenzymes and risk factors. Since Hex B is a sensitive marker for alcohol abuse, we also investigated its serum level in subjects that could be suspected of alcohol abuse. However, we did not find any differences in these subjects compared with the others, possibly due to the relatively short half-life of Hex B after alcohol withdrawal.
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PMID:Serum beta-hexosaminidase isoenzymes are related to risk factors for atherosclerosis in a large population of postmenopausal women. 795 22

Smoking tobacco contributes to and exacerbates many chronic diseases of aging, including hypertension, stroke, COPD, heart disease, and atherosclerosis. It is also associated with an increased risk of peptic ulcers and of cancers of the lungs and oral cavity. Older patients generally continue to smoke because of physiologic and psychological addiction to nicotine. Nicotine administration through gum or patch eases the symptoms of nicotine withdrawal for highly-tolerant patients. Detecting and treating alcohol abuse, depression, or life stress may then make it easier to motivate the patient to quit smoking. Physician advice combined with follow-up visits and phone calls has been shown to be one of most effective methods of getting patients to stop smoking.
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PMID:Smoking cessation: clinical steps to improve compliance. 838 53


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