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

Family physicians should be aware of the potential effects and complications of vasectomy so they can appropriately counsel patients seeking sterilization. Vasectomy produces anatomic, hormonal and immunologic changes and, although not substantiated by clinical studies, has been reputed to be associated with atherosclerosis, prostate cancer, testicular cancer and urolithiasis. Complications of vasectomy include overt failure, occasional sperm in the ejaculate, hematoma, bleeding, infection, sperm granuloma, congestive epididymitis, antisperm antibody formation and psychogenic impotence. Compared with tubal ligation, vasectomy has fewer serious complications and a comparable failure rate.
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PMID:Complications of vasectomy. 823 40

About 42 million couples worldwide, most of whom live in developing countries, have chosen vasectomy as their family planning (FP) method. There has been considerable research on the short and longterm safety of vasectomy. In the 1970s, research on rhesus monkeys indicated an increased risk of atherosclerosis, possible due to an increased level of antisperm antibodies. Later research on vasectomized men in developed and developing countries did not support these animal studies. Epidemiological studies in the US and Scotland showed an increased risk of testicular cancer in vasectomized men. A WHO meeting reviewed these studies and found no logical mechanism for this association. Later research found that vasectomy does not cause testicular tumors or accelerate the development of existing neoplasms. 2 studies in the US in 1990 suggested that vasectomy increases the risk of prostate cancer many years after the procedure. No studies since then have substantiated these findings. Besides, no known biological mechanism or hypothesis can explain the association. Vasectomy and prostate cancer specialists at a meeting of the US National Institutes of Health in March, 1993, agreed that physicians should continue to perform vasectomies and need not change clinical practice. Extrapolation of the US results to other countries is not logical, particularly to countries where prostate cancer is rare. Nevertheless, these recent reports will probably affect FP programs and acceptance of vasectomy in countries where vasectomy is common. Still, the evidence does not justify changes pertaining to vasectomy in national FP programs. Research on the longterm safety of vasectomy should be conducted. In conclusion, vasectomy is still a simple, safe, and very effective FP method.
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PMID:The safety of vasectomy: recent concerns. 832 61

New Zealand had the highest prevalence of vasectomy in the world. A national survey conducted over the period 1983-86 found that 23% of married women aged 25-44 relied upon their husbands' vasectomies for contraception, while only 19% relied upon tubal ligation. It seems that in no other country male sterilization is more common than female sterilization. Vasectomy seems to be at least as effective as tubal ligation and is even less commonly followed by significant complications, despite unfounded scares over time about potential associations with the decreased production of testicular hormone, atherosclerosis, and testicular cancer. There is, however, current cause for concern that vasectomies potentially increase the risk of prostate cancer. Studies have shown the relative risk of prostate cancer to increase with the number of years since vasectomy. One may attribute these findings to chance, bias, confounding, or a causal relationship, with the first two factors being less likely. We have a poor understanding of the genesis of prostate cancer. The World Health Organization convened a meeting in October 1991 to review the existing biological and epidemiological evidence for any such relationship. The organization recommended future research, but concluded that a causal relationship between vasectomy and risk of prostate cancer appeared unlikely and that changes to family planning policies were unwarranted. In New Zealand, however, where the prevalence of cancer before age 75; 400 men die annually. This high rate of mortality has increased in recent decades. Even though the verdict is still out on the link between vasectomy and prostate cancer, New Zealand doctors should be informing candidates for vasectomy about the possible link with prostate cancer, as well as about the risks and benefits of other contraceptive methods.
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PMID:Vasectomy and prostate cancer: is there a link? 833 90

Vasectomy has been recognized as a simple and highly effective contraceptive method. In order to recommend further research on vasectomy, researchers conducted a systematic review of the literature on the safety and effectiveness of vasectomy between 1964 and 1998. Early failure rates are 1%; however, effectiveness and complications vary with experience of surgeons and surgical technique. Early complications, which include hematoma, infection, sperm granulomas, epididymitis-orchitis, and congestive epididymitis, occur in 1-6% of men undergoing vasectomy. Incidence of epididymal pain is poorly documented. Animal and human data suggest that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes following vasectomy are transient. The weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these diseases. The findings indicate that publications to date continue to support the conclusion that vasectomy is a highly effective form of contraception. Future research should include evaluations of the long-term effectiveness of this method, evaluating criteria for post-vasectomy discontinuation of alternative contraception for use in settings where semen analysis is not practical, and characterizing complications including chronic epididymal pain.
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PMID:Safety and effectiveness of vasectomy. 1126 66

Radiotherapy is commonly used in the management of testicular tumors. However, to date the risk of radiation-induced vascular occlusive disease in men following radiotherapy for testicular cancer has not been regarded as a major factor in their long-term care. Several animal studies have shown the importance of established vascular risk factors such as hypercholesterolemia and hypertension in the pathogenesis of radiation-induced atherosclerosis. This report presents three cases of premature chronic iliofemoral arterial disease presenting 5,13, and 16 years following exposure to therapeutic irradiation for the treatment of testicular cancer. The patients were in the age group of 40-45 years and all demonstrated associated known atherosclerotic risk factors. The patients had received radiotherapy in the dose of 3,500-4,000 rads in a standard "dog-leg" fashion to the ipsilateral aortoiliac lymphatic chain. Our results showed that young men treated with radiotherapy for testicular cancer may be targeted from the outset for atherosclerotic risk factor reduction to minimize the risk of development of late chronic occlusive arterial disease. It may be that a cohort of men so treated with historical regimes of radiotherapy and now entering middle age should be screened for arterial disease and risk factor reduction.
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PMID:Synergism between radiotherapy and vascular risk factors in the accelerated development of atherosclerosis: a report of three cases. 1218 69

Testicular cancer patients have an increased risk for coronary artery disease more than ten years after cisplatin-based chemotherapy. We investigated whether vascular changes, including endothelial dysfunction, are present earlier. Ninety chemotherapy-treated testicular cancer patients (median follow-up of seven years) were compared with 44 patients after orchidectomy only and 47 healthy men. Microalbuminuria was present in 10 (12%) chemotherapy patients, one stage I patient and none of the controls. Chemotherapy patients had higher levels of fibrinogen, C-reactive protein (hs-CRP), von Willebrand factor (vWF), plasminogen activator inhibitor (PAI-1), and tissue-type plasminogen activator (t-PA). Chemotherapy patients with elevated PAI-1 (25/90) showed clustering of cardiovascular risk factors resembling the metabolic syndrome. In conclusion, cured testicular cancer patients showed a high prevalence of microalbuminuria and increased plasma levels of endothelial and inflammatory marker proteins, which might progress to more severe endothelial dysfunction and overt atherosclerosis.
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PMID:Microalbuminuria, decreased fibrinolysis, and inflammation as early signs of atherosclerosis in long-term survivors of disseminated testicular cancer. 1501 71

Along with the growing epidemic of obesity, the risk of atherosclerosis, cardiovascular disease morbidity, and mortality are increasing markedly. Several risk factors for cardiovascular disease, such as visceral obesity, glucose intolerance, arterial hypertension, and dyslipidemia commonly cluster together as a condition currently known as metabolic syndrome. Thus far, insulin resistance, and endothelial dysfunction are the primary events of the metabolic syndrome. Several groups have recommended clinical criteria for the diagnosis of metabolic syndrome in adults. Nonetheless, in what concerns children and adolescents, there are no unified definitions, and modified adult criteria have been suggested by many authors, despite major problems. Some pediatric disease states are at risk for premature cardiovascular disease, with clinical coronary events occurring very early in adult life. Survivors of specific pediatric cancer groups, particularly acute lymphocytic leukemia, central nervous system tumors, sarcomas, lymphomas, testicular cancer, and following bone marrow transplantation, may develop metabolic syndrome traits due to: hormonal deficiencies (growth hormone deficiency, thyroid dysfunction, and gonadal failure), drug or radiotherapy damage, endothelial impairment, physical inactivity, adipose tissue dysfunction, and/or drug-induced magnesium deficiency. In conclusion, some primary and secondary prevention remarks are proposed in order to reduce premature cardiovascular disease risk in this particular group of patients.
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PMID:Detection of metabolic syndrome features among childhood cancer survivors: a target to prevent disease. 1906 99